By Tom Swick
Orange County, CA
@IMFtomMyeloma

The 56th American Society of Hematology (ASH) Annual Meeting and Exposition is a truly amazing event, and I am extremely grateful to the International Myeloma Foundation (IMF) for allowing me to be a part of it. This four block area in downtown San Francisco, containing the Moscone Center and Marriott Marquis, is beginning to feel like home.

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I’ll briefly highlight some of things I learned during my time here.

Shaji Kumar, MD, (Mayo Clinic) reported on a phase II trial attempting to show that long-term ixazomib maintenance is tolerable and improves depth of response following ixazomib-Revlimid (lenalidomide)-dexamethasone induction in previously untreated patients. Ixazomib is the leading oral proteasome inhibitor in the pipeline.

Thomas G. Martin III, MD, (University of California San Francisco) reported on a phase IIb dose escalation trial of the anti-CD38 monoclonal antibody drug known as SAR650984, in combination with Revlimid and dexamethasone in relapsed/refractory myeloma. Dr. Martin believes there is a high potential for synergy between the two drugs. To date, the study is showing a 100% overall response rate (ORR) among Revlimid-refractory, non-relapsed patients; and good ORR in all patient subset groups.

Torben Plesner, MD, (Vejle Hospital, Denmark) reported on the safety and efficacy of daratumumab with Revlimid and dexamethasone in relapsed myeloma. The drug was well tolerated in a phase I study. I’m not sure what the “parts” of the trial were, but he reported 100% ORR in part 1, and 87% ORR in part 2.

I heard Bart Barlogie, MD, PhD, (University of Arkansas for Medical Sciences) speak for the first time. He began by saying that anyone who’s heard him before knows that myeloma is curable! One of the drugs in his Total Therapy arsenal is trametinib, which is a MEK inhibitor active against the BRAF gene mutation, and used to treat other cancers like melanoma (yes, melanoma). Whether you agree or not, he considers anyone whose disease is reduced to chronic MGUS to be cured of myeloma.

LGH447 was mentioned in one of the presentations as a pan-PIM inhibitor that is effective against certain types of myeloma. It is under development by Novartis.

Paul G. Richardson, MD, (Dana-Farber Cancer Institute) discussed elotuzumab, and reported that a 20mg/kg dosage was no better than 10. Patients are enrolled in the phase III ELOQUENT trials, and a phase II trial for high-risk smoldering myeloma is in the works.

Rachid Baz, MD, (Moffitt Cancer Center) reported that adding Cytoxan (cyclophosphamide) to Pomalyst (pomalidomide) and dexamethasone improved the ORR in relapsed and refractory myeloma from 39% to 65%.

Martha Q. Lacy, MD, (Mayo Clinic) studied Pomalyst, Velcade (bortezomib), and dexamethasone (PVD) in relapsed, Revlimid-refractory myeloma. The ORR for PVD in these patients was about 85% vs. 25-35% for just PD in similar patients.

MOR-202 is a new anti-CD38 antibody under development by Celgene.

There is much more at ASH than anyone could take in, let alone understand. But as long as I’m “home,” I’ll just put up my feet and watch Monday Night Football.

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