The Myeloma Patients Europe (MPE) team has been busy attending several important international conferences focusing on myeloma and AL amyloidosis.
Main conferences attended were the American Society of Clinical Oncology (ASCO) Annual Meeting 2018 and the European Haematology Association (EHA) Annual Congress 2018. These large-scale meetings bring together oncology and haematology professionals from across the globe to discuss the latest scientific and treatment developments in the field. The scientific and patient advocacy highlights are outlined below.
ASCO and EHA 2018 myeloma highlights
Positive results on chimeric antigen receptor T cell (CAR–T) therapy in myeloma
There has been a lot discussion recently on the role of CAR-T therapy in myeloma, particularly focusing on a specific target expressed on myeloma cells known as “anti-B-cell maturation antigen” (BCMA). During ASCO, Celgene and Bluebird Bio reported updated data from a Phase I trial on their anti-BCMA CAR-T cell therapy bb2121 in patients with multiply relapsed and refractory myeloma. The results highlighted deep and durable responses in the patients and manageable side-effects. You can read the full abstracts here:
- http://abstracts.asco.org/214/AbstView_214_211179.html
- http://abstracts.asco.org/214/AbstView_214_216053.html
There were also a range of different educational and industry-sponsored symposia discussing alternative potential targets for CAR-T cell therapy in myeloma.
Further data on administration of carfilzomib (Kyprolis®)
The results of a Phase III A.R.R.O.W clinical trial were published looking at the difference between once-weekly vs. twice weekly scheduling of carfilzomib in relapsed and refractory myeloma. The clinical trial was exploring a more convenient dosing schedule for myeloma patients. The results found that once-weekly scheduling improved patient progression-free survival (i.e. the length of time before myeloma progresses) and had a favourable risk-profile for patients. You can read the full abstract here and a journal article in the Lancet Oncology here.
Further data on elotuzumab (Empliciti®) in relapsed myeloma
A “late-breaking” abstract published at EHA 2018 highlighted positive results from a clinical trial looking at the monoclonal antibody elotuzumab (Empliciti®) in combination with pomalidomide (Imnovid®) and dexamethasone. The Phase II trial looked at this triple combination vs. treatment with pomalidomide and dexamethasone alone in patients with relapsed and refractory myeloma. The results highlighted that the addition of elotuzumab to the combination prolonged progression free survival by more than five months (10.3 months vs. 4.7 months). You can read further information here.
Further data from ongoing UK study
Further results were published on the NCRI Myeloma XI, a large Phase III clinical trial which enrolled most newly-diagnosed myeloma patients in the UK. Data presented by Dr Charlotte Pawlyn from the Institute of Cancer Research (ICR) in London showed that, whilst clinical practice in Europe often means that patients over 65 do not typically have an autologous stem cell transplantation (ASCT), it is an efficacious option in older, fitter patients. You can read the full abstract here.
Data on daratumumab, bortezomib (Velcade®), melphalan and prednisolone (VMP)
Data from a Phase III clinical trial called ALCYONE was published looking at the combination of daratumumab (Darzalex®), Velcade, melphalan and prednisolone (D-VMP) in patients who are ineligible for autologous stem cell transplantation. The trial looked at D-VMP vs. VMP alone in newly diagnosed myeloma patients ineligible for ASCT and over age 65. Whilst the median PFS figure for D-VMP has not yet been reached (vs 20.4 months in the VMP arm), the study found that D-VMP had a higher overall response rate and more complete responses.
You can see the abstract here.
ASCO and EHA 2018 AL amyloidosis highlights
The main AL amyloidosis highlight was a plenary session at EHA from Prof Giampaolo Merlini which looked that the current diagnostic and treatment options in AL amyloidosis. This was a very prestigious opportunity, where he outlined the critical importance of early diagnosis in AL amyloidosis and the marked improvement that biomarker treatment guided strategies are playing in improving outcomes. This was filmed and will be available from the EHA website in the coming weeks.
Interesting poster presentations during the congresses included:
- The safety run-in of the ongoing Phase III Andromeda clinical trial which is looking at subcutaneous daratumumab, in combination with cyclophosphamide, bortezomib and dexamethasone (CyBorD) vs. CyBorD Alone in newly diagnosed patients: http://abstracts.asco.org/214/AbstView_214_220003.html
- A review at the Mayo clinic of daratumumab based treatment regimens in heavily pre-treated patients: http://abstracts.asco.org/214/AbstView_214_228471.html
- Two studies from Prothena Biosciences Inc looking at the health economic costs systemic amyloidosis: http://www.pharllc.com/wp-content/uploads/2018/06/Hospitalizations-for-amyloidosis-poster.pdf
Patient advocacy sessions
Finally (and importantly), MPE had the opportunity to attend and participate in several EHA patient advocacy sessions designed to discuss the key patient and carer-focused issues. Highlights from these sessions included:
- A panel, chaired by MPE Project Manager Alfonso Aguaron, discussing the clincial trial outcomes and endpoints that matter to patients
- A presentation given by MPE Chief Executive Officer Ananda Plate on quality of life, sexual issues and cancer
- An update from the Innovative Medicines Initiative (IMI) HARMONY project on developing a large dataset in haematological malignancies and defining core outcomes sets. This is a project which MPE is involved in to represent the myeloma patient community, so we were also involved in a workshop to discuss how to define the outcomes in myeloma and ensure they are relevant to patients
The patient advocacy sessions were extremely well-attended this year, emphasising the growing acknowledgement of the importance of quality of life and more holistic considerations for patients and carers, as wells as clinical ones.
Further information
MPE will be running a webinar on EHA 2018 highlights on 3 July 2018 (12:00-13:00 PM CET). The talk will be given by Dr Laurent Garderet, Department of Hematology, Saint Antoine Hospital, Paris, France. Find more information and register in this here.
In the meantime, you can see further information on the two congresses at the links below:
ASCO: https://am.asco.org/program
EHA: https://ehaweb.org/congress/previous-congresses/23rd-c/key-information/
Ananda Plate, Munich (Germany)