Day 1 & 2: The orientation breakfast is a working breakfast to organize our team to have an organized approach to a very complicated scheduled. Dr. Durie and Debbie Birns go to great lengths to review the ASH2017 app to find the most significant oral, education, and scientific sessions for the Support Group Leaders (SGL) to attend.
The first session is the “meeting before the meeting” — IMF Satellite Symposium: Getting Clear Answers to Complex Treatment Challenges In Multiple Myeloma: Case Discussions.
An informative, audience interactive presentation by five of the top myeloma specialists on the following areas:
- Accurately Diagnosing Multiple Myeloma: When Should Systemic Myeloma Treatment Be Initiated? (Dr. Bruno Paiva)
- Individualized Approaches to Treatment Selection for Induction Therapy (Dr. S. Vincent Rajkumar)
- Transplant, Consolidation, and Maintenance: The Role of MRD in Monitoring (Dr. Philippe Moreau)
- Therapeutic Strategies After First Relapse Following Initial Therapy (Dr. Jesus San-Miguel)
- Current and Future Options for Therapy in Patients With Late Relapse (Dr. Brian Durie)
The complex information was presented by way of case studies, evidenced-based graphs, and discussion. Participation through Audience Response System (ARS) allowed attendees to answer pre- and post- questions on how they might approach the care of each patient, and how their answer changed after they heard the evidence. Interestingly, there was often consensus between the five presenters on how they would approach diagnostician and treatments, but not always. For instances, use of PET-CT scans as part of the diagnostic work-up was agreed upon by all except Dr. Rajkumar, who provided sound rationale that this expensive imaging technique is used on an individual basis.
Unfortunately, Atlanta weather interfered with many of the evening and morning plans for this meeting. I was able to meet with members of the IMFs Nurse Leadership Board (NLB) to discuss an important topic of Shared Decision-Making. This was a topic shared on the recent Living Well with Myeloma Series with Dr. Beth Faiman and Charise Gleason. Then the snow happened, preventing us from attending the Scientific Sessions Friday night, IMWG Breakfast, and education sessions Saturday morning.
By late Saturday morning, the snow stopped and sun started, allowing us to attend Celgene’s Patient Partners luncheon which had a focus on Imagination, a great theme for such a forward-thinking conference.
Following, there was a little time to go to the Exhibition Hall to complete my “Vlog” (new term for me!). Check it out, it is my first video blog.
Saturday evening was the much awaited IMF Grant Reception that also included patient stories. Junior and Senior research grants were presented by Dr. Robert Kyle to young, brilliant researchers who have interest in advancing the science of #myeloma. We heard from 4 patients as they shared their inspiring and humorous myeloma journey.
Sunday and Monday were filled with meetings and sessions. We met with Industry partners to discuss continued support of support group leader and IMF activities. Education and Oral Sessions ranged from supportive care, disparity in health care, and treatment options in the spectrum of myeloma. Photos and commentary of the sessions can be seen my Twitter feed @IMFnurseMyeloma.
A few of my highlighted favorites:
Paper #438 by Dr. Andrew Branagan from Massachusetts General Hospital: Two Dose Series of High Dose Influenza Vaccine is Associated with Longer Duration fo Serologic Immunity in Patients with Plasma Cell Disorders. “Patients who received the two-dose series of high-dose influenza vaccine maintained higher rates of seroprotection at the end of the influenza season compared to those who received standard vaccination.” I liked the simplicity of this. A tolerable and easily accessible supportive option.
Paper #903 by Dr. Mark Drayson from University of Birmingham: Tackling Early Morbidity and Mortality in Myeloma (TEAMM): Assessing the Benefit of Antibiotic Prophylaxis and Its Effects on healthcare-Associated Infections in 977 Patients. Patients who were receiving treatment for active MM were randomized to receive 500 mg levofloxacin or placebo tablets once daily for 12 weeks.” This relatively simple supportive care approach reduced rates of febrile episodes and even death.
Paper #741 by Dr. Suzanne Trudel from Princess Margaret Cancer Centre: Deep Dan Durable Responses in Patients with Relapsed/Refractory Multiple Myeloma Treated with monotherapy GSK2857916, an Antibody Drug Conjugate Against B-Cell maturation Antigen (BCMA): Preliminary Results from part 2 of Study BMA117159. More complex, therapy-directed favorite than the previous abstracts. “GSK2857916 monotherapy demonstrated encouraging single agent activity with an ORR of 60%, and deep (51% =VGPR) and durable responses in heavily pre-treated relapsed/refractory MM pts who have limited treatment options.”
Paper #838 by Dr. Ajai Chari from Tisch Cancer Institute, Mount Sinai School of Medicine: Subcutaneous Delivery of Daratumumab in Patients with Relapsed or Refractory Multiple Myeloma: Pavo, an Open Label, Multicenter, Dose Escalation Phase 1b Study. This administration method of DARA SC (1800 mg in 15 mL) and rHuPH20 (30000 U) was well tolerated, reduce infusion time to 3-5 minutes and has fewer than expected infusion related reactions.
Two oral abstracts for treating high risk smoldering myeloma (HRSMM) with very different levels of intensity:
Paper #402 by Dr. Maria-Victoria Mateos from University Hospital of Salamanca: Curative Strategy for HRSMM (GEM-CESAR): Carfilzomib, Lenalidomide and Dex as Induction Followed by HDT-ASCT, Consolidation with KRd Dan Maintenance with Rd. A very intensive approach with curative intent, showing, “After a median f/u of 13 months (1-108), 98% of patients remain free of progression and alive.”
Paper #510 by Dr. Craig C. Hofmeister from Ohio State University: Daratumumab Monotherapy for Patients with Intermediate or High-Risk Smoldering Multiple Myeloma (SMM): Centaurus, a Randomized, Open-Label, Multicenter Phase 2 Study. A less intensive therapy approach that was well tolerated. There were three arms (long, intermediate and short term duration of therapy). The estimated 12-month PFS rates were 98%, 93%, and 89% in Long, Int, and Short, respectively.
Paper #740 by James N. Kochenderfer, MD, National Cancer Institute, National Institutes of Health Clinical Center: Durable Clinical Responses in Heavily Pretreated Patients with Relapsed/Refractory Multiple Myeloma: Updated Results from a Multicenter Study of bb2121 Anti-Bcma CAR T Cell Therapy. ORR were very favorable with tolerable Adverse Effects and no treatment-related mortality.
And finally, an abstract I found interesting having spent the previous 26 years in stem cell transplant was a challenge to the standard of care, melphalan. Paper #681 by Loretta A. Williams, PhD, MSN, BSN from The University of Texas MD Anderson Cancer Center: Symptom Burden of Busulfan and Melphalan Versus Melphalan Alone for Multiple Myeloma. “In this phase III trial, Bu-Mel regimen was safe, and associated with a significantly longer PFS than Mel alone.“. There were higher rates of mucositis and fever, and lesser rates of diarrhea for Bu-Mel vs Mel-only One-hundred-day non-relapse mortality (NRM) was 0% in both arm.
There were a lot of informative education and oral abstract sessions, more than I can list here. A nice review of the highlights and commentary are provided by Dr’s Durie, Mikhael and Richardson in this video.
My ability to provide this review is dependent on my attendance at #ASH17, which was provided through the sponsorship of the IMF. I want to thank the IMF for seeing the value of having support group leaders attend #ASH17 and their continued support of this program.