Hope in the New Year

I am a self-proclaimed science geek.  I love learning about all things related to science. Prior to my cancer-induced retirement, I was a fifth-grade science and math teacher. I adored witnessing the look of accomplishment in my students' eyes when they applied recently learned scientific concepts to successfully solve a design challenge. Discovering a way to get a clay boat to float with a cargo of marbles was always a favorite experiment.

An invitation to attend the ASH annual meeting

Seven years ago, I was asked if I would consider attending the American Society of Hematology's Annual Meeting (ASH) with the International Myeloma Foundation (IMF). The IMF is able to bring a team of support group leaders and patient advocates to ASH thanks to the generosity of industry partners. ASH is the world’s most comprehensive hematology event.  Over 25,000 people from around the world attend this meeting each year.  I didn't give it a second thought.  Of course, this science geek wanted to attend a premier scientific gathering.  I would be part of the IMF’s Social Media Team. The team provides first hand coverage of ASH from the patient perspective. We live tweet from sessions using the appropriate hashtags. Additionally, the social media team members write blogs and conduct video interviews.

I have attended ASH with the International Myeloma Foundation for the past seven years.  Each year, I return home with a sense of hope and gratitude.  This year’s meeting in San Diego from December 1-4 was no exception. There were over 900 myeloma-related abstracts presented. Each abstract highlighted work being done to extend survival and eventually cure myeloma.  Obviously, I was not able to attend all 900 sessions. I decided to focus on immunotherapy at this year’s meeting.

The promise of immunotherapy

Immunotherapy is a way to fight cancer using your body’s own immune system.  In myeloma the monoclonal antibodies daratumumab (Darzalex) and elotumumab (Empliciti) are FDA approved immunotherapies.  At this year’s ASH meeting, there were 123 Darzalex presentations and 32 Empliciti abstracts being presented. The results to a few of these studies were so promising that they may lead to practice changing clinical care. For example, the MAIA study showed that the addition of Darzalex to Revlimid and dexamethasone in patients with transplant-ineligible newly diagnosed myeloma significantly reduced the risk of progression or death by 45%!

CAR-T cell therapy

Besides monoclonal antibodies, CAR-T cell therapy is also a type of immunotherapy that is generating great interest in myeloma.  Studies presented at last year’s ASH showed that CAR-T cell therapy was a promising approach especially in myeloma patients that were refractory to all available treatment options.  This year the results were equally promising.  Over 70 myeloma CAR-T therapy presentations excited the audience. Unfortunately, as of now, CAR-T cell therapy is not proving to be the curative approach that it is in some leukemias and lymphomas.

Antibody drug conjugates

At last year’s ASH, I learned about antibody drug conjugates (ADC) for the first time. Antibody drug conjugates are another type of immunotherapy.  ADCs are being used successfully in many types of blood cancers.  GSK2857916, a BCMA antibody-drug conjugate, has received Breakthrough Therapy Designation from the US FDA for relapsed and refractory multiple myeloma. Breakthrough Therapy Designation quickly advances the development and review of therapies that treat serious conditions and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over available therapy.¹ To me, ADCs appear to be a very promising addition to the myeloma treatment arsenal.  Only time will tell.

Bispecific antibodies

This year, I learned more about another kind of immunotherapy called bispecific antibodies. Bispecific antibodies bind to two specific targets at the same time.  One target is on the cancer cell and the other target is on the T-cell.  The idea is if the T-cell is linked to the cancer cell via the bispecific antibody, the T-cell will do its job and eliminate the cancer. Amgen is bringing their bispecific antibody that they named BiTE (Bispecific T-cell Engager) to the fight against myeloma.  The early investigational results are extremely hopeful.

Hope for the future

I am extremely fortunate to be able to attend ASH and thank the IMF for inviting me and the sponsors for the grants they provided.  Spending a week away from my home and family during the beginning of the holiday season is challenging, but the rewards I reap are well-worth the extra planning it takes to successful do both. I want to spread the hope and gratitude that I have received from spending time attending encouraging oral and poster sessions.  Upon returning from this year’s meeting I am more certain than ever before that a cure for some myelomas will be found in the near future. I want to thank the dedicated doctors and committed researchers who spend long hours advancing this field at lighting speed.  I also want to recognize the selfless, brave patients that agree to take part in clinical trials.

I am entering the new year with hope for a better tomorrow.