By Tom Swick
Orange County, CA
In my first two days at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition in San Francisco, I learned that you need to be ready to go both ways. Rain to sun, sun to rain, Tony Bennett to Village People, and back again. Protests on Market Street and shopping on Union Square.
Friday’s highlight was the International Myeloma Foundation (IMF) Satellite Symposium featuring Brian G. M. Durie, MD, IMF Chairman and Co-Founder; Shaji Kumar, MD, and S. Vincent Rajkumar, MD, from the Mayo Clinic; C. Ola Landgren, MD, PhD, from Memorial Sloan Kettering Cancer Center; Bruno Paiva, MD, PhD, from the University of Navarra, Pamplona, Spain; and Antonio Palumbo, MD, from the University of Torino, Italy. Saturday’s events began at 6:30 am in the bar room of a pool hall, where the semi-annual meeting of the International Myeloma Working Group (IMWG) was held. Following that, I attended a short presentation on phase II trial results for a pipeline drug, and an amazing keynote address by Jesus F. San Miguel, MD, from the University of Navarra, Pamplona, Spain. Finally, I took a walk through the poster hall. There were approximately 100 posters related to myeloma. After viewing about 30, my head exploded.
In keeping with my focus on new drugs in the pipeline, here’s what I learned:
Drs. Kumar and San Miguel both alluded to a very high level of response to elotuzumab in combination with Revlimid (lenalidomide) and dexamethasone, with little toxicity.
Ibrutinib is a BTK inhibitor that has been effective in other blood disorders (e. g. chronic lymphocytic leukemia); the preliminary phase II trial results investigating its use as a single agent or in combination with dexamethasone, in patients with relapsed/refractory myeloma, do not look particularly promising, in my opinion; new trials are planned to investigate its effectiveness in combination with other agents.
Zelboraf (vemurafenib) is effective in BRAF-positive cases; the drug is currently approved for melanoma.
Oprozomib is an oral proteasome inhibitor in early trials.
Daratumumab, a CD-38 monoclonal antibody, is promising.
Panobinostat in combination with Velcade (bortezomib) and dexamethasone failed to show any significant progression-free survival benefit.
I’ve been up for 19 hours now. Thank God For Dex (TGFD).