The American Society of Clinical Oncology will hold its 49th annual meeting May 31 through June 4 in Chicago.
Similar to previous years, more than 25,000 clinical specialists from all over the world are expected to attend the five-day meeting to discuss the current research in cancer treatment and care. The theme for this year’s meeting is “Building Bridges to Conquer Cancer.”
During the meeting, there will be presentations and seminars about all areas of cancer, including many focused specifically on multiple myeloma. The ASCO website currently lists more than 60 myeloma-based presentations (included under “lymphoma and plasma cell disorders”).
The ASCO meeting is one of three annual scientific meetings where important new myeloma-related research findings are reported. The other two key conferences are the annual meetings of the American Society of Hematology (ASH) and the European Hematology Association (EHA). The International Myeloma Workshop, which meets every other year and is focused solely on multiple myeloma, was also held earlier this year.
As in previous years, The Myeloma Beacon will be covering the ASCO 2013 meeting in detail. Readers can expect many articles during and after the meeting about the key myeloma findings.
Organization Of The Meeting
Research findings presented at ASCO and other scientific meetings are generally communicated in either oral presentations or poster summaries.
Oral presentations are usually given for research that is considered particularly important, either because the subject itself is important or the results are based on substantial amounts of evidence (for example, a sizable clinical trial).
Poster research summaries are made available during specific “poster sessions,” when researchers display summaries of their studies on posters in a large exhibition hall.
Compared to the research summarized during oral presentations, the findings in poster summaries generally are in earlier stages of development and may involve only laboratory research or clinical trials with just a small number of patients.
Abstracts for all ASCO presentations are now available. However, the results included in the abstracts are frequently preliminary results that will be updated at the meeting. We therefore provide below brief overviews of the most important myeloma-related studies that will be presented at the meeting. During and after ASCO, we will provide more in-depth summaries of these studies that include the updated data presented during the meeting.
Treatments Under Development
Several of this year’s ASCO presentations will unveil updated results from Phase 1 and Phase 2 clinical trials of potential new drugs under development for the treatment of multiple myeloma.
On June 3, Dr. Henk Lokhorst from UMC Utrecht in the Netherlands will present updated results from a Phase 1/2 study evaluating the safety and efficacy of daratumumab for patients with relapsed and refractory multiple myeloma (abstract). Previous results from this study have shown that daratumumab is the first monoclonal antibody to have single-agent activity against myeloma (see related Beacon news).
In the same session, Dr. Shaji Kumar from the Mayo Clinic will present results from a Phase 1 study of ixazomib (MLN9708) in relapsed and refractory myeloma patients that has completed enrollment (abstract). Previous results from this study and other ixazomib studies have shown that ixazomib, alone or in combination with other myeloma drugs, appears to be effective in newly diagnosed as well as relapsed and refractory myeloma patients (see related Beacon news).
In addition, during poster sessions on June 2 and 3, results from clinical studies of elotuzumab, panobinostat, and the newer drugs quisinostat and TH-302 will be presented. There will also be a poster presentation on preclinical results for SL-401.
In particular, initial results will be presented from a Phase 1b study of quisinostat in combination with Velcade (bortezomib) and dexamethasone (Decadron) for relapsed myeloma patients. Preliminary results included in the poster’s abstract indicate that the combination is tolerable and active, with an overall response rate of 88 percent in patients treated with a median of two prior lines of therapy. Quisinostat is being developed by Janssen Research & Development, a Johnson & Johnson (NYSE: JNJ) subsidiary; it is an oral histone deacetylase inhibitor, which works by increasing the production of proteins that slow cell division and cause cell death. Zolinza (vorinostat) and panobinostat belong to the same class of drugs and are also being studied in combination with Velcade and dexamethasone for the treatment of myeloma.
Initial results from a Phase 1 study of TH-302 plus dexamethasone in heavily pretreated myeloma patients will also be presented during the poster session. Preliminary results in the poster’s abstract show an overall response rate of 22 percent in patients treated with a median of six prior lines of therapy. The lower doses tested appear safe, but the highest dose was associated with severe side effects. Velcade will be added to the combination for Phase 2 of the study. TH-302 is being developed by Threshold Pharmaceuticals (NASDAQ: THLD) and the German pharmaceutical company Merck KGaA. TH-302 is a drug that is activated under low oxygen level conditions, which are common in tumors and the bone marrow of people with blood cancers. It is currently also being investigated in a range of solid tumors.
Additional Research Highlights
During the oral presentation session on June 3, results from several other important myeloma studies will be presented.
First, Dr. Mario Boccadoro from the University of Turino in Italy will present results from a study that compares melphalan-prednisone-Revlimid (lenalidomide) (MPR) treatment with tandem (two back-to-back) stem cell transplantation. It also evaluates the benefit of Revlimid maintenance therapy following either of these previous treatment approaches. According to the abstract for Dr. Boccadoro’s presentation, stem cell transplantation significantly prolongs progression-free survival compared to MPR. Likewise, the results show that Revlimid maintenance therapy significantly prolongs progression-free survival, regardless of initial treatment, with a trend toward improving overall survival.
Then, Dr. Cyrille Touzeau from the University Hospital in Nantes, France, will present initial results from a Phase 1/2 study of Kyprolis (carfilzomib) plus melphalan (Alkeran) and prednisone for older people newly diagnosed with myeloma. The abstract for Dr. Touzeau’s presentation states that initial results from the study compare favorably to those for Revlimid-dexamethasone as well as other combinations of melphalan and prednisone plus a novel agent, such as thalidomide (Thalomid) (MPT), Velcade (VMP), or Revlimid (MPR).
Dr. Jesús San-Miguel from the University Hospital in Salamanca, Spain, will also present updated results from a Phase 3 study of Pomalyst (pomalidomide) plus low-dose dexamethasone compared to high-dose dexamethasone alone for relapsed and refractory myeloma patients (abstract). Interim results from the study have already shown that the Pomalyst combination extends progression-free and overall survival compared to dexamethasone alone (see related Beacon news).
During another talk, Dr. Antonio Palumbo from the University of Turino in Italy will present results from a meta-analysis that investigates the impact Revlimid has on the likelihood of developing a second cancer. The results summarized in the presentation’s abstract show that second blood cancers are more common among people treated with Revlimid, but the abstract states that the increased risk is limited to patients treated with Revlimid plus melphalan, not either drug alone.
Advances In Diagnostics And Management Of Myeloma
During an education session on June 1, myeloma experts will discuss several important topics related to diagnosing and managing multiple myeloma.
The first presentation will be given by Dr. Donna Reece from the Princess Margaret Hospital in Toronto. In her talk titled “Update on the Initial Therapy of Multiple Myeloma,” she will discuss how the use of novel agents has improved the treatment of newly diagnosed multiple myeloma.
Dr. Robert Orlowski from the MD Anderson Cancer Center will give the second presentation, which is titled “Novel Approaches to Treatment of Double-Refractory Multiple Myeloma.” He will discuss novel agents under clinical development that have shown activity in myeloma that is resistant to a proteasome inhibitor, such as Velcade, as well as an immunomodulatory drug, such as thalidomide and Revlimid.
Finally, Dr. San-Miguel will give a talk titled “New Tools for Diagnosis and Monitoring of Multiple Myeloma.” In his presentation, he will discuss the techniques used to evaluate myeloma patients, including how each test can be used to diagnose myeloma and determine a prognosis for patients as well as any drawbacks of each test.
There will also be an education session on June 4, where experts will discuss how to treat several types of blood cancers.
The first presentation will be given by Dr. Palumbo and will be titled “How I Treat Elderly Patients with Multiple Myeloma.” He will discuss the criteria for determining whether an older patient is a stem cell transplant candidate as well as treatment regimens that are options for those who are not transplant candidates.
For more information on ASCO’s 49th Annual Meeting, including the final presentation schedule, abstracts, and information on attending, please see the American Society of Clinical Oncology meeting website.
Beacon coverage of myeloma-related research presented at recent scientific meetings can be found at these links: ASCO 2012 Meeting, EHA 2012 Meeting, ASH 2012 Meeting, and IMW 2013.