By Linda Huguelet
Chattanooga, TN
@IMFlindaMYELOMA

Wow– how do you pick one favorite thing from the entire American Society of Hematology (ASH) Conference? This conference was jam-packed with so many presentations and activities. The myeloma presentations were over-flowing with attendees who were interested in learning more about the latest developments. To sum it up, the overarching thing that I took away from the conference was the tremendous amount of research taking place and the concrete hope that this brings to patients and their caregivers.

After much thought and review of all the outstanding events, I think the one event that best encapsulated the current progress made and the ongoing research that is striving for a cure was the Ham-Wasserman lecture by Dr. Jesus San Miguel. It also answered several of the questions I was looking to be answered while at ASH.

This prestigious lectureship honors Dr. Thomas Hale Ham and Dr. Louis Wasserman, two past ASH Presidents, who contributed greatly to the organization. It is traditionally given by an individual from outside the United States who has made a major contribution to our understanding of an area of hematology research.
Dr. San Miguel from Pamplona, Spain gave a fascinating one-hour talk entitled Multiple Myeloma: A Modern Model for Scientific and Clinical Progress. Given that only four people in 100,000 are diagnosed each year with multiple myeloma, it’s very impressive that someone involved with this type of cancer was invited to give this lecture. This further illustrates how impressive the results in myeloma research have been in the past 15 years, and it indicates that much more progress is ahead of us. It was estimated that over 6,500 people attended his presentation, which is also a testament to how much interest there is in multiple myeloma. To me, all this translates to tremendous hope for all those affected by multiple myeloma.

His presentation began with a discussion on how the genomic abnormalities seen within multiple myeloma make it very complicated to understand and treat. Because of the abnormalities seen within multiple myeloma, he likened it more to a solid tumor cancer than other blood cancers. This complexity leads to the need for more sophisticated gene expression profiling (GEP) so that treatment can become more customized for each patient. This ties in with the Black Swan Research Initiative® underway by the International Myeloma Foundation (IMF) and how a better definition and understanding of minimal residual disease (MRD) will shape the future of myeloma. Although this is very daunting, the variety of treatment combinations available now and those in development give doctors many tools to use to combat this complicated and highly unique cancer.

A few of the highlights from his lecture were the latest theories on when to treat smoldering myeloma patients, the continued value of stem cell transplants, consolidation and maintenance therapies, and the many options for relapsed patients. You can find a synopsis of his lecture on the ASH website by clicking on: http://www.hematology.org/Annual-Meeting/Program/General-Sessions.aspx.

Several of the questions I was hoping to have answered while at ASH were addressed by Dr. San Miguel during his lecture:
Maintenance, or continuous therapy, continues to show improved progression-free survival benefit for most patients, especially those with higher risks due to certain chromosomal abnormalities.

There are a number of combinations that can be considered as maintenance options.

Monoclonal antibodies, such as daratumumab, have been tested as a single agent and an even greater response was shown in combination with Revlimid and dexamethasone.

Many thanks to the IMF for providing me the valuable opportunity to attend ASH this year! I am so excited about sharing the vast information I gathered with members of my networking group, my hematologist, my community, and anyone else that will listen. While having multiple myeloma is a scary journey, it is one that is filled with so much progress and hope for the future.

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