ASH 2006 Highlights
Orlando, Florida
December 9-12th, 2006
Brian G.M. Durie, M.D.
Cedars-Sinai Outpatient Cancer Center
Available Options Continue to Increase
Chronic illness
Cure
Revlimid
BTZ = Bortezomib
BTZ
THAL
THAL
BISPH = Bisphosphonates
BISPH
THAL = Thalidomide
BISPH
Mini-
Mini-
SCT = Stem cell
Palliation
ALLO
ALLO
ALLO
transplantation
SCT
SCT
SCT
HDC = High-dose
HDC
HDC
HDC
chemotherapy
VAD
VAD
VAD
VAD = Vincristine,
STEROIDS
STEROIDS
STEROIDS
STEROIDS
doxorubicin,
RAD
RAD
RAD
dexamethasone
RAD
MP
MP
MP
MP
RAD = Radiation
1950-1960s1970-1980s
1990s
2000s
MP = Melphalan + Prednisone
Genes Being Studied
Genes Correlated with DVTs in Patients Taking
Thalidomide
Drug Metabolism
Morgan, et al.
ASH 2006.
IMF Working Group recommendations, ASH 2006
Thalidomide/ Dexamethasone Frontline
Bortezomib Frontline
Bortezomib Frontline
Bortezomib Frontline
Lenalidomide/ Dexamethasone Frontline
Longer-term follow-up
VGPR/ CR
Ongoing
67%
Lenalidomide/ Dex
Single autotransplant
58%
Rajkumar, et al. ASH 2006
Time to Onset of Osteonecrosis in Myeloma:
zoledronic acid (Z) versus pamidronate
(Aredia [A]: alone or combined)
Data censored at 36 months
25%
36-Month
Events / N Estimate
P = .002
20%
Zometa only
10 / 211
10%
Aredia +/- Zometa 10 / 413
4%
15%
10%
5%
0% 0
12
24
36
Months from start of Aredia or Zometa
Sorting out MGUS using
FREELITE
FREELITE ratio normal
FREELITE ratio abnormal
"Speed Round"
Chromosomes 1q is a poor risk
IMIDs as well as Velcade overcome
poor risk
Several novel combinations are
promising Revlimid/ Velcade; Doxil/
Velcade; VMPT; RMP/ MPT...
One day a week DEX produces fewer
DVTs with Rev/ Dex
Some of Promising New Drugs in Trials
New proteasome inhibitors
Nereus
NP 10052
Proteolix
PR 171
Stat 3/IL-6 inhibitor
CNT 0328
NFB inhibitor
ISIS 345794
HDAC inhibitor
LBH 589
HSP90 inhibitor
KOS 953
Akt inhibitor
KLYP 298
Supportive Care Helps Patients Too

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