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IXth International Myeloma Workshop: Friday, May 23rd, 2003
The Unknown Patient Reports From The IXth International Myeloma Workshop
05.24.03

For some Unknown reason, when the Unknown Patient is at these meetings and on the go from sunrise until past midnight, morning always seems to come too quickly. Friday was no exception, but given that the day was packed with focused sessions from 8am until 6pm, followed by a two and a half hour opening ceremony, the Unknown Patient had to drag his bones out of bed and get them into the shower and over to the congress to make the first meeting.

The International Myeloma Foundation is pleased to be able to provide travel grants for young investitigators who could not otherwise afford the expense to attend these very important workshops. Shown to the left is IMF president Susie Novis with one of this year's travel grant recipients.
The following are brief summaries and pictures from the focused sessions prepared by the Unknown Patient.


Please note that the Unknown Patient is a patient, not a doctor and not a scientist. This summary represents a layman's view of what was said at the conference and should form a basis for raising awareness of issues that could be discussed with a qualified professional. In no way should anything contained in this report be taken as medical advice or form the basis for action without first consulting a qualified medical professional who is familiar with your specific medical situation.


Arsenic trioxide (Trisenox®) in multiple myeloma: current clinical trials and future directions: Chaired by Dr. James Berenson, Sponsored by Cell Therapeutics, Inc. (CTI)


The speakers discussed the mechanisms of action of Arsenic Trioxide (Trisenox®) in multiple myeloma and the experience thus far in vitro (testing of the drug with myeloma cell lines in the laboratory) and in clinical trials with myeloma patients.

Dr. Berenson opened the program with an introduction and overview. He also commented on early experience testing Trisenox® in the laboratory in comibination with Velcade and with Melphalan. He indicated that there is strong evidence based on this testing that combinations of these drugs could be very promising new treatment approaches.


Dr. Mohamad Hussein of the Cleveland Clinic reviewed the extensive experience he has in clinical trials for myeloma patients with Trisenox®. While the data is not yet conclusive, he is optimistic that Trisenox® will become an option for some patients who have relapsed and are refractory to other treatments.

Dr. Heinz Ludwig of Vienna presented the European Trisenox® experience in the lab and in clinical trials. He also shared an observation about myeloma patients in general, indicating that females may require more treatment for bone disease than males. Dr. Ludwig pointed out the importance of hormone therapy for females and exercise for everyone as supportive therapies to maintain bone health.

The overall conclusion of the session is that there may be a role for arsenic trioxide (Trisenox®) in treating relapsed/refractory patients for whom standard therapies are not working.

Thalidomide and IMiDs in multiple myeloma: Chaired by Dr. Bart Barlogie, sponsored by Celgene

Dr. Barlogie was the first investigator to use thalidomide to treat myeloma patients. He did this in response to courageous woman whose husband's disease had become resistant to all treatments. She had taken the initative to contact Dr. Judah Folkman about anti-angiogenesis agents and she facilitated a dialog between Dr. Folkman and Dr. Barlogie that led to the very exciting results that we have seen in the past few years, with many many patients benefiting from treatment with thalidomide. Other speakers at this session included Drs. Alexanian, Dimopoulos, Rajkumar, Hussein and Anderson.

Dr. Barlogie reviewed the experience with thalidomide, both as a single agent, and in combination with dexamethasone. Most of the studies thus far have been with relapsed/refractory patients (those whose disease has relapsed after treatment and is not responding to standard therapies). Other presenters included Drs. Dimopoulos, Rajkumar,Hussein and Anderson. Dr. Rajkimar reviewed the ongoing trial he is conducting using thalidomide with dexamethasone as front-line therapy,

There was a rather spirited discussion of the issue of dosage, with debate about whether the doses routinely being used (200mg) could be lowered without compromising the effectiveness of the treatment. While there is anecdotal eveidece that this may be the case, there remains no conclusive data. The conclusion presented at the session was that "Thalidomide therapy should be individualized to a dose that achieves response and is well tolerated.


Data was presented showing response rates based on experience to date with both newly-diagnosed and relapsed/refractory myeloma (see below.)


Dr. Anderson dicussed his experience with thalidomide in combination with dexamethasone versus conventional chemotherapy (CC.).


Dr. Anderson also discussed the progress that has been made in developing thalidomide analogues (i.e., drugs whose molecular structure is similar to thalidomide but specifically excludes parts of the molecule thought to be responsible for side-effects like somnolence and constipation but not critical to the effectiveness of the drug as a myeloma treatment.) The most progress to date has been with an IMiD (immunomodulatory drug) named Revimid, which is currently in clinical trials.


The doctors presenting at this session are pictured below (l to r, R. Vescio, I. Lieberman, P. Croucher, J. Berenson, P. Greipp)

Dr. Vescio opened the session with an overview of myeloma bone disease.




Dr. Lieberman discussed myeloma bone disease and surgical options for the patient with bone damage.








Drs. Croucher and Berenson spoke about the role of zoledronic acid (Zometa®)




Dr. Greipp spoke about the potenial role of bisphosphonates in people with smoldering myeloma or MGUS.

Dr. Berenson concluded the session with a discussion of new bone disease modulators and conclusions about the management of myeloma bone disease


Second Annual Workshop on Waldenstroms Macroglobulinemia

The Unknown Patient is only human! So, given that he was dead tired, hungry and thirsty, he skipped out of the Waldenstroms workshop because he does not have nor does he know the first thing about Waldenstroms. Sorry! He did manage however, to take a few pictures before vanishing unceremoniously.

The session was led by Dr. Steven Treon(right).


He was joined by the doctors pictured below (l to r, Drs. Pilarski, Dimopoulos, Kyle and Weber)

Opening Ceremony

First up was Anne M. Mann, Executive Director of the Research Fund For Waldenstroms (RFW.)

She was followed by Ben Rude, President of the International Waldenstroms Macroglobulinemia Foundation (IWMF.)

Mr. Rude presented the RFW's Robert A. Kyle award for Waldenstrom Macroglobulinemia to Doctor Meletios Dimopoulos.

Multiple Myeloma Research President Kathy Giusti presented an overview of the foundation's accomplishments and plans.

International Myeloma Foundation President Susie Novis presented an overview of the foundation's accomplishments and plans, focusing on two key projects-- the International Prognostic Indicators (IPI) staging system and Bank On A Cure"!.

Workshop hosts Drs. Jesus San Miguel and Joan Blade were warmly welcomed by the crowd as they offically welcomed all of the participants to the Workshop.

The Rector of the University of Salamanca added his words of welcome and the attendees were then treated a group of songs sung by the University choir.

Everyone was invited to the Patio de Escuelas (Old University Cloister) for drinks and a concert by the local "Tuna" minstrels. However, the Unknown Patient looked at his watch, which read close to 9pm. So he decided to forego the beverages and vocal delights and go off in search of dinner so he could get back to his room and try and download all of these images from his camera and write this page. Needless to say, it was a late night!


Please note that the Unknown Patient is a patient, not a doctor and not a scientist. This summary represents a layman's view of what was said at the conference and should form a basis for raising awareness of issues that could be discussed with a qualified professional. In no way should anything contained in this report be taken as medical advice or form the basis for action without first consulting a qualified medical professional who is familiar with your specific medical situation.


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