Personalizing DNA Damage in Multiple Myeloma

Blood Cancer
Craig Hofmeister, MD, MPH
Emory University


There are over 30,000 patients who are newly diagnosed with multiple myeloma annually in the United States. Multiple myeloma patients that are fit enough are treated with high dose melphalan, a chemotherapeutic, followed by autologous stem cell transplant. This treatment strategy has not changed in 30 years, but it produces the longest overall survival. However, due to 5-fold interpatient variability in melphalan exposure, only 10% of patients are functionally cured, 5% have too high an exposure and die due to transplant-related toxicities, and approximately 20% are melphalan-resistant and relapse within 12 months of transplant. Thus, new methods are needed to improve upon how melphalan is administered to increase the number of patients that achieve a functional cure. This phase I pilot study will assess a real-time exposure-based dosing algorithm that allows for personalized melphalan dosing.

Trial Registration: Identifier: NCT04483206