African Americans face a far higher danger of developing multiple myeloma– especially African American men, who run three times the risk of a diagnosis. These groups are also about half as likely to survive multiple myeloma. Is this because treatment research isn’t working in their favor?
Multiple myeloma is a rare type of cancer that develops in plasma cells, a type of white blood cell that helps make antibodies to fight infections. To learn more about this rare cancer, click here.
Although multiple myeloma occurs most frequently in African American populations, most research focuses on patients of European descent. The problem is that the disease often operates differently, due to genetic differences, in people from different ancestries. There’s a heavy genetic component to this cancer, and depending on the type of mutation a patient has, they may respond differently to various treatments.
Take for instance, the mutation in their TP53 gene. TP53 is usually a gene that helps prevent cancer by preventing tumors from arising, and when there’s a mutation, multiple myeloma has an easier time arising. Patients from European ancestry are 6 times more likely to have this particular form of mutation, and also frequently have the IRF4 mutation.
However, it’s not the only mutation that causes this rare form of cancer. A mutation affecting the BCL7A gene is far more likely to affect African American patients. BCL7A also works to suppress tumors, but it’s still a different gene than TP53. If a cancer therapy works to target the TP53 mutation, as many do, it simply won’t work on somebody with the BCL7A mutation. The therapy would attempt to fix a gene that was working fine. Mutations affecting the AUTS2 and BRWD3 are also far higher in African American populations.
However, since patients of European descent are the most researched demographic, there are far more strides towards treatments for multiple myeloma cause by TP53 mutations. Over the last 20 years, multiple myeloma treatment has improved enormously. Far more patients survive, and there are far more options available. However, multiple myeloma cannot be treated with one blanket cure that works for every patient. Each person battling this cancer has different needs, and the research must reflect that.
