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Monday, January 25, 2021

Myeloma Canada invests a yearly record-high $735,000 in Canadian myeloma research projects

Myeloma Canada invested in more important research initiatives in 2020 than in any other year, thanks to essential fundraising and the generosity of our donors. Some of the major projects that Myeloma Canada is honoured to have contributed to follow:

Canadian Myeloma Research Group: supporting the collaborative national research organization

Myeloma Canada was pivotal in helping to create the original Myeloma Canada Research Network (MCRN), now known as the Canadian Myeloma Research Group (CMRG). We’re thrilled to continue our long-standing relationship with the organization and provide important funds in support of their essential work for the benefit of all Canadians living with myeloma.

The CMRG is a national collaborative research organization whose purpose is to transform myeloma research activity in Canada, thereby accelerating cure. Since its formation, the CMRG has been collaborating with a number of pharmaceutical companies to bring industry clinical trials into Canada, in addition to developing and executing its own made-in-Canada trials that allow hundreds of Canadians living with myeloma to participate.

The CMRG’s research activities are amplified by the creation of the National Myeloma Database platform. The Database platform positions the organization as an international leader in Real World Evidence (RWE) research into multiple myeloma and related diseases. The CMRG’s ‘bench-to-bedside’ research strategy (taking research results from the laboratory into the clinic for the direct benefit of patients) also entails a correlative research platform supported by the CMRG National Myeloma Biobank and the Database.

Redefining risk stratifications in myeloma: the future of precision medicine

While new treatment developments are very encouraging, there is a key piece of the puzzle that has been overlooked. Many research programs focus on killing myeloma cells, however focusing on understanding and predicting WHY and HOW the myeloma develops and comes back is equally important.

Predicting the course of disease using current genetic (FISH) testing methods is limited. Dr Florian Kuchenbauer and his research team at the BC Cancer in Vancouver, BC are working on developing next generation genetic sequencing that will highlight gene mutations not identified by FISH, and are working to re-define risk stratification (high-risk vs standard-risk) by identifying specific genetic patterns.

This new sequencing will eventually serve as an improved prognostic indicator at diagnosis, identify genomic myeloma subgroups at relapse, select and optimize treatments to prolong remissions (especially in high-risk) and help develop new treatments. By initiating next generation sequencing research in myeloma and kickstarting a myeloma dataset in British Columbia, this research will be an exciting step forward toward precision medicine, and may ultimately lead us closer to a cure.

Understanding the role of Natural Killer (NK) cancer cells and immunotherapy drug resistance

Understanding why certain immunotherapies don’t work in myeloma but work very well in other cancers is a key component in our quest for a cure. Unlocking this mystery is the fundamental first step in being able to tailor and design effective, non-resistant immunotherapy drug therapies.

Dr Michele Ardolino from the Ottawa Hospital Research Institute in Ottawa, Ontario, along with his colleagues, may have unlocked the first clue to understanding what happens at the cellular level, specifically with Natural killer cancer cells (a type of immune cell). In a lab study, the team observed that in some instances when NK cells met with a myeloma cell, a phenomenon happened where the two cells transferred DNA from one-another, making the cancerous myeloma cell unrecognizable to the immunotherapy treatment and therefore, ineffective.

Dr Ardolino and his team have initiated a research study to confirm if this lab finding also occurs in human cells. If this important phenomenon holds consistently true in humans, the discovery would be a giant leap forward toward understanding the mechanisms of immunotherapy drug resistance and propel additional research studies in this area.

Newfoundland & Labrador to participate in the CMRG National Myeloma Database

The CMRG National Myeloma Database is an initiative developed by the CMRG to compile data from healthcare institutions across the country into one comprehensive database. A single National Myeloma Database will help researchers better understand the entire treatment landscape in Canada from coast-to-coast, pose new research questions and formulate conclusions, and help define future initiatives.

Thanks to this comprehensive database, the CMRG are international leaders in myeloma Real World Evidence (RWE) research. Until this point, the province of Newfoundland & Labrador has not been able to participate locally due to funding constraints. Through the generous contributions of donors and fundraisers, Myeloma Canada was able to invest research funds in the Healthcare Foundation of St John’s and directly support the initiation of the local database research program in Newfoundland. This significant initiative is under the direction of Dr Debra Bergstrom for the benefit of Newfoundlanders and all Canadians living with myeloma. 

Contributing factors that impact quality of life and overall survival in myeloma

Unfortunately, quality of life and overall survival is not the same for all Canadians impacted by myeloma. The important question is why? What are the factors that seem to contribute negatively to this and how can we work to improve them?

Dr Hira Mian and her research team at the Juravinski Cancer Centre in Hamilton, Ontario are working toward understanding the realities and disparities that people living with myeloma face. Her study, “Symptom burden in transplant ineligible patients with newly diagnosed multiple myeloma: a population-based cohort study” analyzes 15 years' worth of data from tens of thousands of Ontario database entries, taking many factors into consideration including quality of life (i.e., pain, fatigue, depression, nausea, etc. – the same as those trackable in Myeloma Canada’s Myeloma Monitor application). Equally, the study looks at overall survival and compares variables such as age, sex, geography, socio-economic status, drug dosing/treatment regimes, and more.

Given the large set of data available from the entire province, conclusions are highly meaningful for all Canadians. The outcome of this important study may enable us to improve overall quality of life and survival rates by identifying strengths, gaps, weaknesses and opportunities in our healthcare system; better understand patient outcomes (based on these variables); define and investigate future research questions, i.e., when you change one variable in the equation (such as age or geography), does the quality of life factor change (such as fatigue or pain)?

This innovative patient-centric study is an exciting step forward for understanding and helping to improve the lives of those impacted by myeloma. Results of Dr Mian’s work may also help Myeloma Canada identify important gaps and opportunities for future research and programs.

Allogeneic stem cell transplant research

Myeloma is considered to be a very heterogeneous disease, meaning that there are many factors involved. This heterogeneity plays a large role in why some individuals have better prognoses than others. In addition to the current arsenal of drug therapies, new therapeutic strategies are necessary, especially for those with poorer prognoses.

Of all available treatments for multiple myeloma, the only one that has demonstrated a “curative-intent” is the allogeneic transplantation of hematopoietic stem cells, sometimes also known as a third-party or allo transplant. Historically, there were significant toxicities and negative experiences associated with this treatment, so allogeneic transplantation was never considered a standard treatment.

Over the past 20 years, the department of hematology and oncology at Hôpital Maisonneuve-Rosemont in Montreal, Quebec, under the leadership of Dr Richard LeBlanc and Dr Jean Roy, has developed significant expertise in allogeneic transplants for the treatment of hematological cancers, and more specifically, myeloma. Today, thanks to ongoing research, overall results of allogeneic transplants have markedly improved. This is largely due to a combination of better donor selection, better supportive therapies and more effective antibiotics.

Myeloma Canada is excited for the future of this ongoing important research and is proud to have once again contributed to the Myeloma Canada Research Chair in Multiple Myeloma at the Maisonneuve Rosemont Hospital to support this unique work.

For more information on myeloma research in Canada, visit our Research page.

For an up-to-date list of myeloma drug availability and coverage across Canada, check out our interactive Myeloma Drug Access Navigator  under Drug Access section.

To learn more about Myeloma Canada’s achievements over the past 15 years, please click here.