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Developing a Clearer Picture of Multiple Myeloma

The Paula and Rodger Riney Foundation supports the work of a researcher who is pushing toward a cure

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earning you have cancer can be an emotional and overwhelming time. Many people are at a loss for what to do. But when Rodger Riney was diagnosed with multiple myeloma five years ago, he realized he was in a unique position to help others. The founder of Scottrade, Riney sold his company to TD Ameritrade and established the Paula and Rodger Riney Foundation with proceeds from the sale.

The foundation focuses on funding innovative research projects and novel approaches to treat — and ultimately cure — multiple myeloma.

“There’s a lot of research around cancer, but not multiple myeloma,” Riney said. “I wanted to help find a cure for this disease.”

Paula and Rodger Riney

Pushing boundaries

One of the research projects the Paula and Rodger Riney Foundation supports is the work of world-renowned multiple myeloma expert C. Ola Landgren, M.D., Ph.D., chief of the Myeloma Program, leader of the Experimental Therapeutics Program, and co-leader of the Tumor Biology Program at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.

Dr. Landgren has been involved in early drug development for multiple myeloma for many years, and he has served as principal investigator for several clinical studies. In addition to his interest in drug development, Dr. Landgren and researchers in his lab are pioneers in developing novel methods to identify minimal residual disease (MRD) in patients with multiple myeloma. MRD refers to the small number of cancer cells left in the body after treatment.

As treatment for multiple myeloma has improved, more and more patients are achieving complete response (CR) after therapies. Unfortunately, in many patients who achieve CR, there’s still evidence of low levels of tumor cells that have escaped treatment and have the potential to cause a recurrence of disease years later.

Funding from the Rodger and Paula Riney Foundation will support Dr. Landgren’s lab in developing advanced methods to sharpen the assessment of the treatment response, including improving the accuracy of identifying if a patient is MRD positive or MRD negative.

“In patients who are MRD positive, we have developed methods to capture residual tumor cells and perform full genomic characterization, including whole-genome and single-cell sequencing,” Dr. Landgren said. “Using novel genomic assays, which can be used on very small numbers of tumor cells, we are able to do full genomic characterization in patients who are MRD positive.”

Until recently, it wasn’t possible to conduct advanced genomic studies in samples with a small number of tumor cells. In 2020, in collaboration with the Wellcome Sanger Institute in the U.K. and Memorial Sloan Kettering Cancer Center in New York, researchers developed strategies to analyze MRD-positive samples with full resolution.

Landgren’s lab is now moving quickly, particularly in the area of genomic signatures. But he believes the new studies have brought them much closer to a multiple myeloma cure than they were just a year or two ago.

C. Ola Landgren, M.D., Ph.D.

“When conducting a comprehensive analysis of these large datasets, we are interested in genomic signatures, which is a type of pattern recognition when investigating the details of the tumor cell DNA,” Dr. Landgren said. “Our team has developed novel algorithms for data analyses. By applying our new methods, we have been able to identify new and important ‘signals’ or genomic lesions — in datasets that formerly were considered just to be a lot of noise. This has opened new opportunities for us to better understand the underlying genomics of tumor cell development and recurrence.”

The new advances could mean that MRD testing will help physicians personalize treatments for patients and watch for signs of recurrence.

“I am convinced that we — hopefully soon — will have MRD-driven treatment strategies in the multiple myeloma field,” Dr. Landgren said. “At the same time, it’s clear to me that a key scientific path forward is to optimize the approach to find residual disease and characterize the residual cells.”

“If there are no tumor cells left — or if there are tumor cells left, and we can capture them and characterize them with advanced sequencing assays — these trajectories are both on the path to a cure.”

The exciting research taking place in Dr. Landgren’s lab gives Riney hope for the future.

“I’m thankful to be able to support and advance the research at the University of Miami,” Riney said. “Our hope is that Dr. Landgren’s work will lead to a better understanding of the disease, which of course leads to better treatment — and, hopefully, a cure.”

UNIVERSITY OF MIAMI MEDICINE
SPRING 2021