Summary of ASH 2019

Before presenting my ASH summary, I’ll mention a late-breaking abstract presentation that I was unable to attend early Tuesday morning describing a phase III trial called Candor for relapsed/refractory multiple myeloma patients (RRMM), comparing (Kyprolis) carfilzomib and dexamethasone with or without Darzalex (daratumumab). The abstract #LBA-6 showed that the addition of dara decreased the risk of progression and death by 37%. And the Kyprolis, dexamethasone, and daratumumab arm produced nearly 10 times as many MRD- results at 12 months as well as better & deeper responses overall response rates (ORR) (84% vs 75%) and complete response (CR) (29% vs 10%).

Here’s my preliminary summary of ASH 2019, and I emphasize “preliminary” because I’ll be learning more about the interpretation ASH 2019 results as I listen to follow-up presentations by multiple myeloma expert oncologists over the next 1-2 months. While some years are focused on the usage of newly approved drugs, this past year only had one approval–selinexor for a limited audience.

Rather, the importance of this year’s ASH is that we have another year of results in different area of myeloma treatment from high-risk smoldering multiple myeloma (HR-SMM) to induction therapies for newly diagnosed to immune therapies initially being tested for RRMM patients. For HR-SMM patients we’ve seen results of Revlimid or Revlimid plus dexamethasone to delay progression and are now starting to see early outcomes for “curative” intense treatments.

For induction, we’re seeing more and more combinations including Dara, which result in better responses. It seems we’re not far away when four drugs become the standard initial regimen.

And for RRMM patients, we have more trial readouts for immune therapies such as CAR-T, ADC (Antibody Drug Conjugates), Bi-Specific T-Cell Engagers (more focus on AMG-701 with easier administration) and naked mAb’s (TAK-079, Isatuximab).

It’s really quite amazing to look at all the available treatments and those on the horizon compared to when I was diagnosed 25 years ago when the choice was either pills (melphalan plus predinosone) or a transplant. This means we have a responsibility to ourselves to keep informed.

Wishing you the best of health!

— Jack Aiello, on Twitter @JackMAiello