Do Racial and Ethnic Differences Impact Outcomes in Multiple Myeloma?
In recent years, the topic of health care disparities has been prevalent, as more organizations shift their focus from wanting to reduce disparities to eliminating them. And while the work is being done to make this a reality, there are still diseases that need better understanding such as multiple myeloma.
Similar to other cancers, the rare blood disease is twice as common in Black people as compared to their white counterparts, and Blacks and Hispanics are less likely to receive novel treatments for multiple myeloma. But the reason for these racial and ethnic differences is still unknown.
Researchers at Moffitt Cancer Center want to understand why. They have presented a study during the American Society of Hematology annual meeting investigating demographic, clinical and molecular features, including tumor mutations and clonal hematopoiesis, in a diverse population of patients with multiple myeloma to explain the reasons for the clinical disparities.
“What we were trying to do is look at patient characteristics that may drive clinical disparities in diverse multiple myeloma patients,” said Lauren Peres, Ph.D., M.P.H., a researcher in the Cancer Epidemiology Program at Moffitt. “We are looking at things like age of onset, treatment utilization and treatment delays to see if they differ according to race and ethnicity, to try to get some understanding as to why health disparities exist for racial and ethnic minority patients.”
The study included a diverse group of over 490 multiple myeloma patients. The results showed that Blacks and Hispanics are often diagnosed with rare blood cancers at younger ages. It also showed that Blacks have a longer wait time for hematopoietic cell transplant, also known as bone marrow or stem cell transplant. Since this is a critical treatment, it may result in Blacks having a delay in care.
The results also identified unique tumor mutations by race and ethnicity. Some commonly mutated genes were found in Hispanics but not observed in Blacks. This finding will help researchers understand the applicability of different types of therapy that target these tumor mutations in each racial and ethnic group.
“A lot of the genetic and molecular differences we found have direct therapeutic implications,” said Peres. “We’re seeing mutations in some populations, but not others, and that might speak to the fact that race and ethnicity should be considered in therapeutic selection and risk stratification for patients moving forward.”
While Blacks may often see a delay in treatment, the study also showed that this group of patients had similar outcomes to white and Hispanic patients.
Peres says that with similar access to care, outcomes and differences by race and ethnicity may no longer be a factor.
“The big thing is ensuring patients have similar access to quality care, particularly at places like Moffitt that can offer the latest breakthroughs and cutting-edge therapies,” Peres said.
And while this is the first study to examine the differences among racial and ethnic groups of patients diagnosed with multiple myeloma, researchers at Moffitt are eager to continue the study with the ultimate goal of identifying personalized management and optimizing outcomes for diverse patients diagnosed with the rare blood cancer.
