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OMIC-Y, You’re So Fine: Multi-Omic Advancements in Hematology

December 9, 2023
Brittany Knick Ragon, MD, (@BKRagonMD)
Atrium Health Levine Cancer Institute, Charlotte, NC

“You’re so fine, you blow my mind.” – Toni Basil  

“Mind-blowing” is the best way to describe the advancements in multi-omic precision medicine within the field of hematology. Omics is a collective characterization referring to the study of a particular subject in its totality, providing a trove of comprehensive data that can be used to achieve the exactness required for precision medicine to personalize patient care. In addition to its prominent role in many abstracts being presented in oral and poster sessions, omics will shine elsewhere at #ASH23. The Scientific Symposium Multi-Omics Driven Precision Hematology (Monday, 2:45 p.m. -4:00 p.m., Convention Center, Room 30) is chaired by Pamela Becker, MD, PhD, whose mastery of multi-omics has marked her as an authority in precision medicine for blood cancers and rare blood disorders. From her mastermind, this session was conceived, as she “realized how much the field of functional precision medicine had advanced in the recent few years, and that we were finally able to predict responses from multi-omic data on individual patients.” Her enthusiasm for precision medicine is palpable, and there is no doubt that those vested in multi-omic precision medicine will, according to Dr. Becker, “change the paradigm of practice.”  

Dr. Becker said this session will summarize the “tremendous advances in the methodology of molecular (genomic/transcriptomic) analysis as well as the single-cell analysis of current functional drug screening and show examples in acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).” It will also “highlight the power to find treatments for the most rare blood disorders without much in the way of proven or approved treatment options especially when relapsed or advanced.”

Jun J. Yang, PhD, will begin the session by reviewing the current paradigm of precision medicine in blood cancers, using ALL as a model to demonstrate that direct profiling of drug sensitivity ex vivo can complement genomics to inform treatment selection. Following this, Mika Kontro, MD, PhD, said he will “discuss the latest advances for personalizing AML therapies using functional screening,” and highlight the VenEx trial, which he articulates will “demonstrate the predictive value of ex vivo drug sensitivity testing to identify patients with AML who can benefit from the azacitidine-venetoclax regimen.” Not to be missed is the session closer, Dr. Becker herself, who mentioned that she intends to “demonstrate how a combination of molecular understanding and functional testing can provide complementary data to optimize therapy and yield exceptional responses, now collectively beyond ‘N-of-1.’”  

With omics at the helm, this symposium is one that is certain to unveil novel and thoughtful approaches to some of our still elusive diagnostic and treatment dilemmas. Both Drs. Kontro and Becker expressed a sentiment that the goal of their efforts is to use multi-omic precision medicine to personalize our approach to patient care, with the ultimate aim of minimizing morbidity and optimizing outcomes.   

Omics will also be highlighted in the Spotlight Session Advances in Genomics: Tools Finally Opening the Molecular Secrets of Burkitt Lymphoma (Monday, 10:30 a.m. - 11:45 a.m., Manchester Grand Hyatt San Diego, Grand Hall D). The session will be co-chaired and presented by Ryan Morin, PhD, and Ludmila Prokunina-Olsson, PhD.

“Genomics has begun to reshape our understanding of the causes of [Burkitt lymphoma] including the interplay between environmental factors and population genetics on disease risk and etiology,” Dr. Morin shared. Importantly, there are many challenges in the treatment of Burkitt lymphoma, particularly in low-resource settings. Using genomics to optimize diagnostic approaches and reveal potential therapeutic targets may help overcome the continued challenges in managing Burkitt lymphoma and will hopefully provide more accessible means of diagnosis and treatment for the particularly vulnerable in low-resource settings. 

 “We are beginning to see that BL can be more robustly categorized based on genetic and molecular commonalities between patients, which may allow new therapies to be explored in a more rational and targeted manner,” Dr. Morin said. He added, “We are entering an era where standard diagnostic methods for lymphoid cancers will include genomic testing including tissue and liquid biopsies. This has already begun to lead to exciting new clinical trials in other entities such as diffuse large B-cell lymphoma, and we hope to see this similarly impact BL treatment in the coming years.”  

The message is clear: The era of omics has arrived. To complete your “Omics Eras” tour at the annual meeting, check out the additional omics sessions on multiple myeloma, stress and aging hematopoiesis, clonal hematopoiesis, and lymphomagenesis 

Lastly, I would be remiss not to conclude by expressing my sincere apology for imparting on to you, dear reader, the “OMIC-Y” earworm that I have not been able to silence since first conceiving this article. OMIC-Y, “You're so pretty, can't you understand?”  

Dr. Ragon indicated no relevant conflicts of interest. 

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