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Rafael Fonseca, M.D., is the director for Innovation and Transformational Relationships at Mayo Clinic's campus in Arizona.
Dr. Fonseca has a broad range of research interests, including clinical trials for the treatment of myeloma and related conditions, a better understanding of the genetics of myeloma and related conditions (including the clinical implications), new drug development (including harnessing the cells' metabolism to develop effective therapies), myeloma bone disease, pharmacoeconomics, and policy. His research laboratory is currently composed of five full-time technologists and three postdoctoral fellows.
Genetics of myeloma. Dr. Fonseca and his colleagues have been instrumental in defining the genetic nature of myeloma cells and how this relates to clinical outcomes and progression. His studies in this area have begun a systematic evaluation of monoclonal gammopathy of undetermined significance (MGUS) plasma cells by molecular and cytogenetic methods. Ultimately, Dr. Fonseca wants to understand the nature of the clone, clinical and biologic significance of the abnormalities, and order of acquisition of abnormalities. He is also interested in the factors permissive for the significant genomic instability observed in the plasma cell neoplasms.
Dr. Fonseca's laboratory was the first to describe that the two main pathways in myeloma pathogenesis, hyperdiploid versus nonhyperdiploid, are dictated by the presence of IgH translocations. Further, his lab was the first to show that this dichotomy is existent since MGUS, and was among the first to describe the presence of the same genetic abnormalities in MGUS as those seen in myeloma, including the high-risk genetic features.
The cumulative research efforts of Dr. Fonseca's laboratory have led to a better understanding of myeloma and related diseases, and unlocked novel treatment options for patients and provided context for the pharmacoeconomic implications of new therapies.
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