Dr Kaddoura on Challenges Integrating Whole Genome Sequencing Into Clinical Practice in Myeloma

"Using whole genome sequencing information, we've been able to enhance our clinical prognostication, identify mechanisms of drug resistance, and so on. The main challenge is that it remains an expensive test and it is more time consuming, so it hasn't yet been implemented routinely into clinical practice."

Marcella Ali Kaddoura, MD, assistant professor, Department of Medicine, the Division of Myeloma, University of Miami, Miller School of Medicine, Sylvester Comprehensive Cancer Center, discusses current challenges in integrating whole genome sequencing (WGS) or similar approaches into routine clinical practice for myeloma, and how information from this sequencing approach could help tailor treatment for patients with this disease.

WGS is increasingly recognized for its ability to enhance clinical prognostication and identify mechanisms of drug resistance in multiple myeloma, Kaddoura begins. Despite its potential, routine clinical implementation remains limited due to high costs and time constraints, she says. However, given the depth of molecular insights it provides, WGS is expected to play a critical role in the future management of myeloma, Kaddoura emphasizes.

A key advantage of WGS is its ability to identify predictive biomarkers that can refine treatment selection, Kaddoura says. By detecting genetic features associated with drug resistance, WGS enables clinicians to preemptively alter therapeutic approaches, avoiding ineffective treatments and minimizing unnecessary toxicity, she explains. Conversely, in patients with genomic profiles suggesting high sensitivity to a particular therapy, WGS can support more targeted, personalized treatment strategies, Kaddoura adds. This level of molecular precision is particularly relevant in myeloma, where therapeutic decision-making remains complex due to disease heterogeneity, Kaddoura notes. By integrating WGS into clinical practice, oncologists could enhance risk stratification, optimize drug selection, and improve patient outcomes, she summarizes.

Although challenges such as cost and turnaround time remain, ongoing advancements in sequencing technologies and data interpretation are likely to improve accessibility, Kaddoura continues. As WGS becomes more feasible for routine use, it has the potential to transform the paradigm of personalized medicine in multiple myeloma, allowing for more precise and effective treatment strategies, she concludes.