Detection of CCND1 Overexpression By RNA-Seq from Tna Samples As a Surrogate for t(11:14) Translocation Traditionally Measured By FISH in Multiple Myeloma Patients for Improved Patient Care

Background: Multiple myeloma (MM) is a blood cancer type affecting plasma cell in bone marrow. MM is heterogenous in nature but t(11;14)(q13;q32) translocation is a common prognostic marker among MM patients. One of the most frequent oncogenic drivers involved in this chromosomal rearrangement is CCND1 (Cyclin D1) gene translocation downstream to the immunoglobulin heavy chain (IGH), which results on overexpression of CCND1, thus promoting abnormal cell proliferation. Oncogenic CCND1 RNA levels can result from translocations such as t(11;14), gene amplifications, increased transcription rates and/or RNA stability. Indeed, CCND1 RNA overexpression has a favorable prognostic value for patients treated with high doses of chemotherapies but important challenges remain in accurate detection of CCND1 RNA levels. Currently, FISH is the gold standard method for detecting t(11:14) translocations at the DNA level. However, it cannot detect CCND1 overexpression. Therefore, a method that can detect CCND1 overexpression levels, as well as in frame transcripts has clinical implications. In the current study we leveraged in-use NeoGenomics Heme TNA single tube NGS assay to enable the detection of CCND1 RNA overexpression as a complementary test to FISH testing.