The American Society of Hematology orASH? isthe preeminent professional society concerned with the causes and treatments of blood disorders. This year the society will have their Annual Meeting from December 7 to 10 in New Orleans, Louisiana. During this meeting – the organizers expect more than 20.000 attendees from more than 100 countries to attend – exciting clinical studies and updates affecting the daily clinical practice will be presented.
“The Science of blood is probably as complex as blood itself and while we are busy with treating patients with hematological disorders and research to find better treatments, we also aim to educate the public on how blood affects their health. As part of this approach, we help patients — and people in general — understand the importance of recognizing the warning signs of some of the more common and sometimes deadly blood diseases by developing educational materials but also by teaching doctors to better help their patients,” explained professor Janis L. Abkowitz, MD, (photo 1) the current president of the American Society of Hematology and head of the Hematology Division, Clement A. Finch Professor of Medicine, and Adjunct Professor of Genome Sciences at the University of Washington. Seattle, WA, USA.
Exciting news and important developments
This year some of the excitingstudies are dealing with developments in personalized medicine and improved treatments for patients too old or too ill for highly toxic therapy in populations with a median age higher than 70 years of age, who are usually not included in clinical studies. But this is slowly changing and during the Annual Meeting study results will be presented that include older patients. For example, a very interesting French study [1]was conducted by a team of physicians including Thierry Facon, MD from the Hopital Claude Huriez, in Lille, France, saidStephanie J. Lee, MD, MPH, (Photo 2) a Professor of Medicine at the University of Washington and a Member of the Fred Hutchinson Cancer Research Center in Seattle, WA, USA. “Thestudy results, which will be presented on Sunday, December 8, 2013 show how treatment of newly diagnosed Multiple Myeloma Patients, who are not candidates for a hematopoietic cell transplant, with lenalidomide plus dexamethasone until disease progression, results in better Progression Free Survival or PFS ? which is defined as the length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse,” she continued.
This year some of the exciting studies are dealing with developments in personalized medicine and improved treatments for patients too old or too ill for highly toxic therapy in populations with a median age higher than 70 years of age, who are usually not included in clinical studies…
Chronic Lymphocytic Leukemia
Another interesting studydiscusses the treatment of patients with chronic lymphocytic leukemia and co-existing medical conditions. [2] This study, which will bepresented on Sunday, December 8, 2013, is a so called head-to-head comparison in which a trial drug is matched head-to-head or one-on-one with the standard treatment. “The results of this study show a statistically significant and clinically meaningful prolongation of progression free survival and higher complete response rate for patients with chronic lymphocytic leukemia and co-existing medical conditions or co-morbidities treated obinutuzumab (Gazyva?; Genentech) plus chlorambucil versus rituximab (Rituxan?; Genentech) plus chlorambucil,” Lee said.
“There is also a late breaking and exciting study that shows the results of the oral PIK3 inhibitor Idelalisib for previously treated chronic lymphocytic leukemia in patients unable to receive chemotherapy because of comorbidities,” she continued. [3] “The researchers, including Richard R. Furman MD from Weill Cornell Medical College in New York, found that the trial drug provides a better Overall Survival (OS) compared to retuximab in this difficult to treat patient population. The results were such that the based on a review of efficacy and safety, an independent Data Monitoring Committee watching over the trial recommended stopping the study early.”
Presidential Symposium
Each year, one of the highlights of the Annual Meeting is the presidential symposium. This year’s symposium highlights genomic sequencing, which has provided many new insights into the pathogenesis and progression of both benign and malignant hematologic disorders. “Taken together with insights from large-scale RNA and protein analyses, this information has stimulated new research directions that are beginning to reveal the pathways and regulatory events that promote the growth and differentiation of hematopoietic cells and regulate hemostasis,” professor Abkowitz noted.
“However, this new information has raised several important questions. Are these findings sufficiently robust to direct clinical decisions in individual patients? What are the successes of personalized medicine? What is its promise and what are the obstacles? How should a hematology clinician evaluate current (and soon-to-be available) data and integrate this information into patient care? During the Presidential Symposium, three experts will discuss these issues,” she continued.
“As part of the presidential symposium, James R. Downing MD (Department of Hematology-Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA)will present his own and others? work that defines the mutational events in childhood acute lymphocytic leukemia and acute myeloid leukemia. He will provide an introduction to genomics and discuss how understanding leukemia-specific mutations and their consequences can help guide the care of children with acute leukemia. Matthew J. Walter (Oncology, Washington University School of Medicine, St. Louis, MO, USA)will discuss the use of whole-genome sequencing of patient DNA to study myelodysplasia at diagnosis and at disease progression. He will discuss new insights into the diagnosis of myelodysplastic syndromes and how the clonal and subclonal architecture of might have an impact on clinical decision making. And finally, David Ginsburg MD (University of Michigan, University of Michigan and Howard Hughes Medical Institute, Ann Arbor, MI, USA)will talk about new insights into the pathogenesis of bleeding and clotting syndromes and the contributions of genetic modifiers to disease severity,” Abkowitz said. “So, I really think that this year the presidential symposium is definitely a must-attend and something to look forward to.” But in addition to the symposium, there are many other exciting studies.
Other studies and presentations
“During the annual meeting a lot of other exciting presentations will given. For example, on Monday, December 9, 2013,Niccolo Bolli, MD, Ph.D from the University of Cambridge in Cambridge, United Kingdom will present the results of a study investigating the the genomic event underlying multip
le myeloma pathogenesis and evolution,”Abkowitz noted. “This study provides new insights into the genomic architecture of multiple myeloma, and will help us identify molecular alterations associated with progression of disease and development of drug resistance.”[4]
There are also two new studiesaboutprecision medicinediscussing why Calreticulin mutations in JAK2V617F negative MPD should not be overlooked and discussions about novel therapies, including the E Donnall Thomas lecture by Katherine A. High, MD, from Children’s Hospital of Philadelphia discussing gene therapy for hemophilia. Another exciting presentation is about novel technologies, including so-called NK barcoding and genetic modification for hemoglobinopathies,Abkowitz concluded.
“?.and there is a presentation by Wendy B?guelin, Ph.D from the Weill Cornell Medical College, New York City discussing how epigenetic changes can cause lymphoma and a discussion about erythroid factor erythroferrone and its role in iron homeostasis by L?on Kautz, Ph.D, from UCLA in Los Angeles on Sunday December 8, 2013,”Stephanie Lee added.
This article is, in part, based on a the preview broadcast with Joni AldrichonCancer Radio on W4WN and W4CS in Association with iHeart Radio. This program aired on November 25, 2013.
For more information:
[1] Initial Phase 3 Results Of The First (Frontline Investigation Of Lenalidomide + Dexamethasone Versus Standard Thalidomide) Trial (MM-020/IFM 07 01) In Newly Diagnosed Multiple Myeloma (NDMM) Patients (Pts) Ineligible For Stem Cell Transplantation (SCT)
[2] Head-To-Head Comparison Of Obinutuzumab (GA101) Plus Chlorambucil (Clb) Versus Rituximab Plus Clb In Patients With Chronic Lymphocytic Leukemia (CLL) and Co-Existing Medical Conditions (Comorbidities): Final Stage 2 Results Of The CLL11 Trial
[3] Phase 3, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Efficacy and Safety of Idelalisib and Rituximab for Previously Treated Patients with Chronic Lymphocytic Leukemia (CLL)
[4] Whole Exome Sequencing Of Multiple Myeloma Reveals An Heterogeneous Clonal Architecture and Genomic Evolution
Also see:
Highlights of 55th ASH? Annual Meeting, New Orleans, LA [Overview]
Photo 1: Janis L. Abkowitz, MD. Photo 2: Stephanie J. Lee, MD, MPH.Photo courtesy: Seattle Cancer Care Alliance.
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