ASH is over but its memories are fresh. My strongest impression of the meeting is that multiple myeloma treatment advances continue to be significant at this huge yearly event. Dr. Durie explained there were an amazing 939 abstracts relating to myeloma at ASH this year. At the IMWG (International Myeloma Working Group) meeting, he said that this group of the world’s premier myeloma leaders now has 240 members. Our treatment options continue to expand. At the IMF’s Friday Satellite Symposium, Dr. Rajkumar explained that, “In the USA, you can get any salvage option you can think of.” That is a good kind of problem, but it really is a problem because even our experts don’t know what treatment approach is best once we relapse.
CAR-T cellular therapy has moved from just interesting discussions two years ago to now a major topic of posters, abstracts, and oral presentations. BiTEs bi-specific cellular immunotherapy will have a major impact on myeloma treatment. Celgene’s anti BCMA CAR-T cell therapy bb21217 demonstrated an overall response rate (ORR) of 83% in heavily pre-treated relapsed/refractory multiple myeloma patients. Patients responded within just one month and those responses deepened over time.
Venetoclax continues to look quite promising for subsets of myeloma patients, and a new agent Melflufen appears to be an effective alkylator. Selinexor results from two clinical trials showed significant efficacy in patients resistant to five types of myeloma treatment (penta-refractory). I predict based on the reported trial results that Selinexor will be our next FDA-approved treatment for myeloma, and that it will occur in early 2019.
TOURMALINE 3 trial results confirmed that Ninlaro (Ixazomib) is an effective oral proteasome inhibitor (PI) to use for maintenance therapy. Thirty percent of myeloma patients are unable to continue Revlimid maintenance so this is a valuable alternative.
My fondest memory will be the warm and supportive interactions between the SGLs invited to attend. We were a close group. All of us had the opportunity to hear Tom Brokaw and then personally interact with him at the end of his stirring presentation. When he learned we were fellow patients, he asked each of us how long we have had the disease. He seemed quite pleased to hear Yelak and I report we have successfully lived with myeloma for over 20 years. Mr. Brokaw has personally changed from initially wanting to keep his diagnosis private to now being a well-recognized face and voice to spread multiple myeloma awareness. Good for him!
In summary this was an exciting ASH showcasing continued myeloma progress. Thanks to the IMF we SGLs were able to attend and share our findings with fellow myeloma patients via website blogs, twitter, and Facebook.
Jim Omel MD
Follow me on Twitter @IMFjimMYELOMA.