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Dr. Rafael Fonseca of the Mayo Clinic Scottsdale discusses today's and tomorrow's myeloma genetic approaches image

Dr. Rafael Fonseca of the Mayo Clinic Scottsdale discusses today's and tomorrow's myeloma genetic approaches

Posted on: Oct 14, 2013
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Description

Radio Dr. Rafael Fonseca, MD, Mayo Clinic Scottsdale Interview date: October 11, 2013

Dr. Rafael Fonseca describes his research focus on genetic markers for myeloma and how they can become predictors for disease type and progression. He shares his belief that MGUS starts quite early, possibly even as early as childhood and that other genetic triggers cause it to become myeloma. He explains myeloma tests and how he and the Mayo Clinic focus more heavily on the FISH test and the gene expression profile test to determine risk and prognosis over cytogenetics. He notes that half of MGUS patients have translocations (or places where chromosomes have swapped places) and describes how that translocation will never change, even if secondary genetic markets change after treatment. He predicts that gene sequencing will be the up-and-coming approach to help find what "triggers" inactive MGUS to turn into myeloma. He also describes how a gene-specific approach is still early in its use but cites a study example of where this has already been done (the Cereblon gene's effect when using IMID drugs like lenalidomide).  He describes the patients' need to educate themselves and specific questions they can ask to make sure their FISH test and gene expression profile are done correctly.  He shares the wide range of active clinical trials at the Mayo Clinic - from MGUS to smoldering and then to advanced disease stage using a variety of approaches including combination therapies, a monoclonal anti-CD38 study as well as an early gene-targeted study called CDK5. He also explains a study using NAB-Paclitaxel (an iteration of Taxol, a drug used for other cancers) that is used for advanced myeloma resistant to other therapies.    The live mPatient Radio podcast with Dr. Rafael Fonseca

Overview

Radio Dr. Rafael Fonseca, MD, Mayo Clinic Scottsdale Interview date: October 11, 2013 

Dr. Rafael Fonseca describes his research focus on genetic markers for myeloma and how they can become predictors for disease type and progression. He shares his belief that MGUS starts quite early, possibly even as early as childhood and that other genetic triggers cause it to become myeloma. He explains myeloma tests and how he and the Mayo Clinic focus more heavily on the FISH test and the gene expression profile test to determine risk and prognosis over cytogenetics. He notes that half of MGUS patients have translocations (or places where chromosomes have swapped places) and describes how that translocation will never change, even if secondary genetic markets change after treatment. He predicts that gene sequencing will be the up-and-coming approach to help find what "triggers" inactive MGUS to turn into myeloma. He also describes how a gene-specific approach is still early in its use but cites a study example of where this has already been done (the Cereblon gene's effect when using IMID drugs like lenalidomide).  He describes the patients' need to educate themselves and specific questions they can ask to make sure their FISH test and gene expression profile are done correctly.  He shares the wide range of active clinical trials at the Mayo Clinic - from MGUS to smoldering and then to advanced disease stage using a variety of approaches including combination therapies, a monoclonal anti-CD38 study as well as an early gene-targeted study called CDK5. He also explains a study using NAB-Paclitaxel (an iteration of Taxol, a drug used for other cancers) that is used for advanced myeloma resistant to other therapies.    The live mPatient Radio podcast with Dr. Rafael Fonseca

On this episode
Healthtree contact Rafael Fonseca, MD

Rafael Fonseca, MD

Rafael Fonseca, MD, is the Getz Family Professor of Cancer, Professor of Medicine, interim Executive Director of the Mayo Clinic Comprehensive Cancer Center, Director for Innovation and Transformational Relationships, and a consultant in the Division of Hematology/Oncology at the Mayo Clinic in Arizona. Dr. Fonseca’s practice has focused on the diagnosis and treatment of plasma cell disorders and leading the multiple myeloma team in its effort to understand the disease and its impact on patients. In his laboratory, Dr. Fonseca has led his team of researchers in concentrating on the genetic nature of the clonal cells of plasma cell disorders. He is also interested in myeloma bone disease, prognostic markers and development of new therapies. Throughout his training and career, Dr. Fonseca has received numerous awards and honors, including the Young Investigator Award in Hematology (Celgene – Achievement Awards for Clinical Research in Hematology), the Damon Runyon-Walter Winchell Clinical Investigator Award, and the International Waldenström Macroglobulinemia Research Award. Most notably, he is a Mayo Clinic Distinguished Investigator, the highest academic distinction given to investigators at his institution. Dr. Fonseca holds memberships and serves in positions for organizations such as the American Society of Clinical Oncology, the American Society of Hematology, the American Association for Cancer Research, and the International Myeloma Society. His research has been funded by the National Cancer Institute (R01, P01, SPORE), the Leukemia and Lymphoma Society, the Multiple Myeloma Research Fund, and the Damon Runyon Cancer Research Fund, for which he also serves as a clinical investigator. Dr. Fonseca serves as reviewer and in editorial capacities for medical publications including Blood, Lancet, Nature Medicine, Cancer Cell, Leukemia, and the New England Journal of Medicine, among others. He is a frequent reviewer of grants and sits on the SPORE grant review panel. He has given many national and international presentations as a visiting professor and has authored more than 300 articles, book chapters, editorials, abstracts, and letters.
Healthtree contact Jennifer Ahlstrom

Jennifer Ahlstrom

Myeloma survivor, patient advocate, wife, mom of 6. Believer that patients can help accelerate a cure by weighing in and participating in clinical research. Founder of the HealthTree Foundation.
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