ASH 2012: A PREVIEW
Dr. Brian Durie, Chairman of the IMF, provides a preview of the myeloma news he expects to be most interesting at the 2012 American Society of Hematology (ASH) Annual Meeting being held December 8-11 in Atlanta, Georgia.
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11.15.12 |
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There are over 700 myeloma related abstracts this year. The abstracts fall into 4 major groups—very much as in the past.
- New drug trials
Results with carfilzomib (Kyprolis®) and pomalidomide top the list with multiple presentations both oral and posters. The combination of carfilzomib/pomalidomide is very promising in the truly relapsed/refractory situation. Several presentations confirm pomalidomide efficacy in relapse populations, including combined with dexamethasone or prednisone and/or with added cytoxan or Biaxin (“ClaPD”). Earlier promising data include results with Daratumumab (an anti-CD38), Dinaciclib (anti-CDK inhibitor: SCH727965), CP-Trail inhibitor, plus follow-up with drugs, such as Elotuzimab, Panobinostat, MLN 9708, ONX 0912, Bendamustine and BHQ 880.
- Frontline options
There are 2 major aspects. First is the use of carfilzomib combinations in the frontline setting. These include with Revlimid, Cytoxan, and thalidomide. Excellent VGPR and stringent CR results are reported, which are very encouraging. The second aspect is the longer term follow-up with Velcade studies, including SQ Velcade and once/week Velcade combinations. Particularly important are: VMPT-VT results, the benefit of Velcade in high-risk disease, the value of Velcade in sequential regimens, retreatment, and maintenance, plus in new combinations, such as with Bendamustine.
- Biology and molecular genetics
There are many, many abstracts covering a broad range of topics. Most interesting are data which clarify the role of Cereblon as a protein which helps mediate IMiD activity. Revlimid is especially dependent upon this protein. Pomalidomide has efficacy mediated by alternate pathways. Several abstracts provide new information about the value or potential value of Hevylite and Freelite testing. Genetics in the elderly, the new evidence that Ip22- and Ip32- changes have independent negative prognostic importance and a prognostic classification using microRNA, are some topics covered related to molecular genetics.
- Myelodysplastic syndrome (MDS) prior to the onset of myeloma and myeloma treatment
Data from the NCI and Mayo Clinic teams support the finding of evidence of MDS in about 20% of patients with smoldering myeloma. The obvious implication is that this should be known at the time of transition to active myeloma as a basis for best treatment selection.
ASH 2012 Myeloma Abstracts https://ash.confex.com/ash/2012/webprogram/keywordindexm.html
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