Here I am at the 57th American Society of Hematology (ASH) Annual Meeting and Exposition in Orlando, Florida. The atmosphere is electric; the schedule is hectic. I am jet-lagged and sleep deprived.
I promised to report all the news about immunotherapy and drugs in the pipeline. Over the first two days, I attended the International Myeloma Working Group (IMWG) meeting, and several informative sessions, including Global Advances in Myeloma Treatment, and others that reported results from various clinical trials. I regret that there is not much to say about my chosen topics, but I expect the coming days to be better.
A few new drugs were called out, barely in passing. Paul G. Richardson, MD, mentioned Opdivo (nivolumab), which is a monoclonal antibody already approved for treatment of melanoma and lung cancer. While presenting data from the Eloquent-2 trial that led to the approval of Empliciti (elotuzumab), he projected that combinations of Empliciti with Opdivo and Pomalyst (pomalidomde) would be studied soon. In response to a question from the audience, Dr. Richardson stated that we have an “embarrassment of riches” stemming from the recent drug approvals and new treatment options.
Jesus F. San Miguel, MD, PhD, mentioned Sylvant (siltuximab), an anti-IL-6 chimeric monoclonal antibody. Sylvant has been FDA approved for the treatment of patients with multicentric Castleman’s disease (MCD), and is under investigation for several other malignancies, including myeloma.
In other sessions, Keytruda (pembrolizumab) and marizomib (NPI-0052) were mentioned. Keytruda is another monoclonal antibody approved for treatment of melanoma and lung cancer. Marizomib is a proteasome inhibitor, like VELCADE® (bortezomib), Kyprolis® (carfilzomib), and Ninlaro (ixazomib).
Saturday night, the IMF held its Media and Grant Awards Reception at the Funky Monkey. My personal highlight was encountering Robert A. Kyle, MD, in a conversation with some of my fellow support group leaders. If you don’t know, Dr. Kyle, now in his eighties, is a Mayo Clinic physician who is considered to be the pioneering myeloma expert. I found him giving my colleagues a very detailed history of the use of corticosteroids in myeloma. I stopped taking dexamethasone this year, in favor of Medrol (methyl prednisolone), and asked him what he thought about that alternative corticosteroid. He responded with a smile and a nod of approval toward the relative mildness and lower toxicity. He is also a proponent of steroid dose reduction (e.g., 20 mg vs. 40 mg) when appropriate.
When I was first diagnosed in 2007, I found that sending e-mail blogs to my relatives was very therapeutic. I adopted a writing style in which everyone I mentioned needed a nickname. Brian G. M. Durie, MD, even before I met him, became the “King of Myeloma”. So what do you call the man who came before the King? With all respect, and no offense intended toward anybody’s beliefs, I’ve decided that to me, Dr. Kyle will forever be the “Myeloma Messiah”.
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Orange County Multiple Myeloma Support Group