Sunday, Onyx and Posters

I only attended a couple of presentations today, both concerning unrelated donor transplants. The first showed that in various area of the world there's significantly less GVHD in areas like Japan and Scandinavia as compared with N. America. The second examined peripheral blood stem cell transplants (PBSCT) vs Bone Marrow transplants, showing Chronic GVHD higher in PBSCT (53%) compared with BM (42%). However the PBSCT method (about 75% of today's transplants) showed benefits in other areas (e.g., better engraftment and better overall survival at 2 years). Since unrelated donor transplants (allo's) are rare for most MM patients, this information is not particularly relevant but still interesting to me.

So I thought I'd talk about a meeting I had with Onyx (Carfilzomib). They are building their Patient Services group and wanted feedback from MM patients such as myself and others. In addition to providing some financial help that will be income-based rather than asset-based, their goal is to address the patient (and caregiver's) complete experience. With direction from oncology nurses on staff, patients will be connected with orgs such as the Cancer Support Community (51 locations in the US, aka Wellness Center) for help with mental and physical well-being. Or a patient may be connected with the Chronic Disease Fund for transportation and logistics services. Or finally patients might be connected with IMF, MMRF, and LLS for medical-related help. We provided lots of feedback and suggestions but I'd say we were all impressed with the goals that Onyx has laid out for themselves to develop an integrated approach to support.

Over the last 2 days I've also looked at many posters with research details, a few I've listed below:

1. Another example of synergy by combining Revlimid (expresses HM1.24...this isn't good) with AHM, an anti-HM1.24 antibody and helping an initial set of 4 relapsed/refractory (R/R) MM patients.
2. In 30 R/R MM patients, ARRY-520 shows durable responses in this Phase I trial. And in a Phase II trial of 32 patients, there was single-agent activity (13% Partial Response (PR)). So this will be combined with Dex, Vel + Dex, and Carfilzomib in future trials.
3. The protocol RVD -> SCT -> RVD (2 cycles) -> R maintenance in a Phase II trial shows 52% Complete Response (CR) and 94% Overall Response Rate (ORR). This represents a 10% improvement in CR (3% improvement in ORR) over CR and ORR at the end of the SCT.
4. Velcade-Bendamustine-Dex (VBD) showed ORR 58% in R/R MM patients (57) including those R/R to Velcade (ORR 58%) and Revlimid (ORR 50%). In another trial of 40 R/R MM pts, VB (but no Dex!) showed a 47% ORR.
5. Response rates to Carfilzomib were comparable in R/R MM normal-risk patients (158) with high-risk (at least one of del13, hypodiploidy, del 17, t(4:14), or t(14:16) risk factors) patients (71)
   

Are your eyes glazed over yet? Mine are. And to think tomorrow is referred to as "Myeloma Monday" when trial results are presented for many new potential MM drugs and regimens. Gotta get a good night's sleep since presentations run from 7am till 6pm.

A bit tired,
Jack Aiello