The tremendous progress in our understanding of the molecular biology of myeloma made in the last decade has been driven by new technologies such as gene mapping and gene expression microarrays. The advent of next-generation sequencing technology means that within 5 years, the recurrent genetic abnormalities of myeloma at a DNA level will have been defined and the discovery phase of myeloma genomics will largely be over. Correlative science occurring within the context of ongoing clinical trials is determining the significance of these lesions, including clinico-pathological correlation and translational laboratory research. Many of the new lesions are potential therapeutic targets, and the challenges lie in determining which of these lesions are driver mutations and therefore important to target, and which are passenger mutations and therefore not central to the disease pathogenesis. Further work will be required to determine the best combination of drugs to use especially as a number of lesions may be present within the same signaling pathways.
Expert Rev Hematol. 2012;5(6):603-617. © 2012 Expert Reviews Ltd.