I look forward every year to Annual ASH Meeting, whether I’m attending in person or experiencing it from home via Twitter, blogs, and professional writers. At ASH we learn new advances in treating, evaluating, and living with myeloma. Immunology has become a central focus of recent ASH meetings and #ASH18 #IMFASH18 will be more of the same. Daratumumab, elotuzumab, isatuximab, CAR-T therapy, bivalent antibodies, antibody drug conjugates, and BiTEs, tell us the age of enhanced immune system attack on cancer is a reality. It is here! We have made such outstanding progress that newly diagnosed myeloma patient’s average life expectancy has more than doubled….probably tripled….since my era of diagnosis in 1997.
We have such outstanding treatments now that new measures of effectiveness are needed. Stringent CR is no longer good enough as a measure of success. Now the debate is MRD- negative by two methods at astounding levels of detection of one myeloma cell in a million normal cells. How can we use this remarkable response clinically? How or when can we rely on MRD-negative to stop treatment? Is that safe? When should MRD levels be checked, and can we ever declare that we have cured myeloma? Dr. Durie and others have said we are undoubtedly curing some patients now, but who? How do we know that?
My interest in ASH will be any opportunity to learn about monitoring myeloma treatment. Such an opportunity might be found at the BMT CTN Myeloma Intergroup meeting held before the official start of ASH. Opportunities will occur in posters, oral presentations, side meetings with pharma companies, and even happenstance hallway discussions with world myeloma experts. I might even discover some up-and-coming company advertising a new method of cell detection in the vast exhibition hall. That is the excitement of ASH. All of us who attend will learn new things, and all of us support group leaders attending ASH at the kind invitation of the IMF will do our best to report those findings to others in blogs, tweets, pictures, and reports. Thank you to the IMF and the sponsors who fund us, for inviting us to attend ASH. We attendees will work late into each night to do our best to report what we find.
Jim Omel, MD