Teresa Miceli: Reflections and Take-aways from ASH

By Teresa Miceli
Rochester, MN

As I return from the 56th Annual American Society of Hematology (ASH) meeting, I reflect on another amazing experience. The hope, the inspiration, the knowledge– and this is just from the support group leaders (SGL). I am impressed with the depth of knowledge the “non-medical” SGLs have– not only of “their” multiple myeloma, but about myeloma in general. We know that Myeloma is not just one disease but a complex variety of differing side effects and test results. The SGLs bring a baseline understanding of myeloma and gather more for themselves, as well as information to bring back to their support group members. Intensive days, starting at 7a.m., going until 10p.m., filled with meetings, education sessions, networking, and impacting the multiple myeloma community in a positive way.

A robust schedule made it difficult to divide my time, but I tried to get to some very key sessions. Here are my general takeaways from the meeting:

• Further evidence of the safety and efficacy of carfilzomib in the frontline and relapsed setting
• Promising prospect of new classes of drugs being added to the armamentarium: monoclonal antibodies (MABs) like daratumumab, elotuzumab and SAR650984; HDAC inhibitor panobinostat
• Redefining criteria for active Myeloma (SLiM CRAB?) to include 60% bone marrow plasma cells, free light chain >100, >1 bone lesion on MRI +/- CRAB.
• There continues to be much discussion of when to start therapy for high risk smoldering myeloma
• Discussion on defining minimal residual disease (MRD), how to consistently test for it, and how to use those result when directing treatment.
• All-oral three-drug regimen ixazomib+Revlimid+dexamethasone is active and well tolerated

In addition to therapy related sessions, I also attended interesting session on quality and health outcome. It was no surprise to hear that the cost of medications can prevent patients from having access and being compliant with their prescribed care (https://ash.confex.com/ash/2014/webprogram/Session5387.html). There is disparity in access to treatment. Treatment advances in multiple myeloma have disproportionately benefited those who are young, white, and have a higher socioeconomic status (SES) (https://ash.confex.com/ash/2014/webprogram/Session5746.html).

I don’t believe there was any “earth shaking” information provided at this year’s meeting of the ASH, but I do believe the continued message received is that of promise and hope: promise from researchers that there is continued work on advancing the science and treatment of myeloma, and hope of ultimately finding a cure.
Please see my Twitter posts at @IMFnurseMyeloma, and “like” the Rochester MMSS Facebook page for more.