New generation pharmacotherapy in elderly multiple myeloma patients

Comparison of the Freiburg and Charlson comorbidity indices in predicting overall survival in elderly patients with newly diagnosed multiple myeloma

Multiple myeloma occurs primarily in elderly patients. Considering the high prevalence of comorbidities, comorbidity is an important issue for the management of myeloma. However, the impact of comorbidity on clinical outcomes has not been fully investigated. We retrospectively analyzed patients with newly diagnosed myeloma. Comorbidities were assessed based on the Charlson comorbidity index (CCI) and the Freiburg comorbidity index (FCI). The CCI is a summary measure of 19 comorbid conditions. FCI is determined by performance status, renal impairment, and lung disease. This study included 127 patients with a median age of 71 years. Approximately half of the patients had additional disorders at the time of diagnosis, and diabetes mellitus was the most frequent diagnosis (18.9%). The most significant factors for prognosis among patient-related conditions were a history of solid cancer and performance status (ECOG ≥ 2). The FCI score was divided into 3 groups (0, 1, and 2-3), and the CCI score was divided into 2 groups (2-3 and ≥4). FCI was a strong prognostic tool for OS (P > 0.001) and predicted clinical outcome better than CCI (P = 0.059). In conclusion, FCI was more useful than CCI in predicting overall survival in elderly patients with myeloma.

Function-first approaches to improve target identification in cancer

Target discovery for cancer is undergoing a sort of revival with an increasing need for improved therapeutics. Likewise, the strategies to discover new and better therapeutic targets have come full circle, with greater emphasis placed upon targets that are functionally relevant to the disease process. In this article, we review the evolution of cancer target discovery and discuss random homozygous gene perturbation, an emerging technology that combines the practicality of screening for new targets by emphasizing function as the primary criterion, with cutting-edge advances in gene-based screening of all potential targets in a cell.