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November 24, 2017 – New research indicates that one-size treatment for one form of blood cancer likely does not fit all, particularly when it comes to ethnic differences of patients. Thus, African-American men are three times more likely to be diagnosed with multiple myeloma, however, most scientific research on the disease has been based on people of European (Caucasian) descent. That trend is problematic considering that
African-Americans, the most at-risk population for multiple myeloma, have different genetics that can affect how this type of cancer progresses and what kind of targeted therapies are most effective.
A new study just published in PLOS Genetics shows that multiple myeloma patients of European descent were six times more likely than their African-American peers to have mutations in the TP53 gene, a tumor suppressor gene that helps prevent cancer. Patients of African-American descent, on the other hand, experienced heightened mutations in the BCL7A gene, a different tumor suppressor gene. Overall, the research team analyzed the genetic sequencing data of 718 multiple myeloma patients and found that patients of African-Americans descent had increased mutations in the genes for BCL7A, BRWD3 and AUTS2, while patients of European (Caucasian) descent had more mutations in the genes for TP53 and IRF4. According to the researchers, these data come out of the largest and ethnically most diverse genomic study of multiple myeloma to date. Thus, they found that in their study of 719 patients, 127 patients were of African-American descent and 591 were of European (Caucasian) descent.
About 30,280 people will be diagnosed with the cancer this year in the US, and about half of them will survive longer than five years, according to the National Cancer Institute. However, according to the authors of the present study, this discrepancy might well arise from clear molecular differences in multiple myelomas between patients of African-American descent and European (Caucasian) descent. Thus, a multiple myeloma therapy that targets TP53 would not be as effective for patients of African-American descent as it would be for patients of European (Caucasian) descent because that therapy would be trying to fix the wrong mutated gene.
Traditionally, in certain geographical areas of research at the molecular and clinical level, there seems to exist a certain bias towards research based on individuals and patients of Caucasian ethnic background. As the present study illustrates, this bias has to be resolved in order to provide equally effective therapies (not only in oncology) to all members of truly diverse populations with a multitude of ethnic backgrounds. After all, very obviously, ethnic background matters.