University of Milan, Department of Clinical Sciences and Community Health, F. Sforza, 35 - 20122 Milan, Italy.
Expert Opin Biol Ther. 2013 Jun;13 Suppl 1:S55-68. doi: 10.1517/14712598.2013.793305. Epub 2013 Apr 24.
Multiple myeloma is a fatal malignant proliferation of clonal bone marrow Ig-secreting plasma cells, characterized by wide clinical, biological, and molecular heterogeneity.
Herein, global gene and microRNA expression, genome-wide DNA profilings, and next-generation sequencing technology used to investigate the genomic alterations underlying the bio-clinical heterogeneity in multiple myeloma are discussed.
High-throughput technologies have undoubtedly allowed a better comprehension of the molecular basis of the disease, a fine stratification, and early identification of high-risk patients, and have provided insights toward targeted therapy studies. However, such technologies are at risk of being affected by laboratory- or cohort-specific biases, and are moreover influenced by high number of expected false positives. This aspect has a major weight in myeloma, which is characterized by large molecular heterogeneity. Therefore, meta-analysis as well as multiple approaches are desirable if not mandatory to validate the results obtained, in line with commonly accepted recommendation for tumor diagnostic/prognostic biomarker studies.
多发性骨髓瘤是一种致命的克隆性骨髓分泌免疫球蛋白的浆细胞恶性增殖,其特征是临床表现、生物学和分子异质性广泛。
本文讨论了用于研究多发性骨髓瘤生物临床异质性背后的基因组改变的全球基因和 microRNA 表达、全基因组 DNA 分析和下一代测序技术。
高通量技术无疑使人们更好地理解了疾病的分子基础,对高危患者进行了精细分层和早期识别,并为靶向治疗研究提供了新的思路。然而,这些技术可能受到实验室或队列特异性偏倚的影响,并且受到预期大量假阳性的影响。在多发性骨髓瘤中,这一方面非常重要,因为其具有很大的分子异质性。因此,如果不是强制性的,也需要进行荟萃分析和多种方法来验证所获得的结果,这符合肿瘤诊断/预后生物标志物研究的普遍建议。