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The 64th American Society of Hematology (ASH) Annual Meeting will be held from December 10-13 in New Orleans, Louisiana.

According to ASH, there are “typically, more than 5,000 scientific abstracts submitted each year, and more than 3,000 abstracts are accepted for oral and poster presentations through an extensive peer review process.”

This year, there are 263 orals (sessions and oral presentations combined) and over 750 posters (sessions and abstracts combined) related to multiple myeloma. The Saturday, Sunday, and Monday sessions will include oral presentations as well as educational and poster sessions, with 52 sessions in total for the three-day oral presentations (at 6 abstracts per session) and three larger sessions each evening (between 6:00-8:00 p.m.) for posters. 

Meanwhile, the Friday Satellite Symposium will be held on December 9th and will include the IMF’s Satellite Symposium, A Conversation with the Myeloma Experts: Making Sense of the Evolving Treatment Landscape, with yours truly chairing the event along with speakers, Shaji K Kumar, MD (Mayo Clinic—Rochester, MN); Thomas Martin, MD (UCSF Medical Center—San Francisco, CA); Jesús San-Miguel, MD, PhD(University of Salamanca—Salamanca, Spain); Philippe Moreau, MD (University Hospital of Nantes—Nantes, France); and S. Vincent Rajkumar, MD (Mayo Clinic—Rochester, MN). 

Topics for discussion will include:

  • How to determine risk of progression for smoldering MM
  • When to treat patients with smoldering MM
  • Optimal induction therapy for “average” patients with newly diagnosed MM; patient/disease factors changing treatment approaches
  • Ideal duration of therapy for first-line MM
  • Selecting therapy at first relapse
  • Individualizing therapy for an “average” patient after multiple relapses; patient/disease factors changing treatment approaches
  • Therapy considerations after BCMA-targeted treatment
  • Review of 2023 myeloma treatment algorithm

Highlights

With regards to the IMF’s interest and participation in this year’s ASH Annual Meeting, these are the highlights.

iStopMM Project

As was the case in ASH 2021, the iStopMM (Iceland Screens, Treats, or Prevents Multiple Myeloma) Project will be presenting multiple abstracts this year—with 4 oral presentations and 6 poster abstracts. The excitement surrounding these abstracts was described by iStopMM Project principal investigator Dr. Sigurdur Y. Kristinsson of the University of Iceland in his recent tweet. The IMF is proud to support this program.

The four iStopMM oral presentations include: 

  • Abstract #103: Prevalence of MGUS Is High in the iStopMM Study but the Prevalence of IgA MGUS Does Not Increase with Age in the Way Other Immunoglobulin Subtypes Do 
  • Abstract #105: Sars-Cov-2 Vaccinations Do Not Lead to Progression of Monoclonal Gammopathy of Undetermined Significance: Results from the Population-Based iStopMM Screening Study 
  • Abstract #107: Predicting the Need for Upfront Bone Marrow Sampling in Individuals with MGUS: Derivation of a Multivariable Prediction Model Using the Prospective Population-Based iStopMM Cohort 
  • Abstract #967: Transient M-Proteins: Epidemiology, Causes, and the Impact of Mass Spectrometry: The iStopMM Study 


There will be three oral presentations on December 10, Saturday and one on December 12, Monday plus six poster presentations on the evenings of December 11, Sunday and December 12, Monday. The findings are truly changing the landscape for the understanding of early disease such as monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). 

An iStopMM team member will lead an educational session on smoldering multiple myeloma on Monday afternoon, December 12th.

CURE Trials

There have been two such trials linked to the IMF’s Black Swan Research Initiative® (BSRI) —the CESAR Trial [Abstract #118: Curative Strategy (GEM-CESAR) for High-Risk Smoldering Myeloma (SMM): Post-Hoc Analysis of Sustained Undetectable Measurable Residual Disease (MRD)] and the ASCENT Trial (Abstract #757: Fixed Duration Therapy with Daratumumab, Carfilzomib, Lenalidomide and Dexamethasone for High-Risk Smoldering Multiple Myeloma-Results of the ASCENT Trial). 

The Spanish CESAR Trial will be updated while the ASCENT trial results will be presented for the first time. Very high levels of MRD negativity have been noted with these KRd-based regimens with ASCT in the case of the CESAR Trial (KRd + ASCT) and plus Daratumumab in the case of the ASCENT trial (Dara – KRd).  Further follow up is still required to assess the longer term sustained MRD negativity beyond 5 years.

CAR T-cell Therapy

A notable related presentation is the use of CAR T-cell therapy for high-risk newly diagnosed multiple myeloma (HR NDMM) in Frontline therapy. 

Abstract #366: Phase I Open-Label Single-Arm Study of BCMA/CD19 Dual-Targeting FasTCAR-T Cells (GC012F) As First-Line Therapy for Transplant-Eligible Newly Diagnosed High-Risk Multiple Myeloma from Shanghai, China will be presented by Juan Du (Shanghai Changzheng Hospital, The Second Military Medical University—Shanghai, China) on December 10, Saturday in the afternoon. 

It seems that this novel CAR T-cell therapy is well-tolerated and produces a high level of MRD negativity. There will be considerable interest in the full details, including new and fast manufacturing.

MRD Testing

Of importance and related to MRD assessment (in such trials) is a new blood flow method in Abstract #865: Ultra-Sensitive Assessment of Measurable Residual Disease (MRD) in Peripheral Blood (PB) of Multiple Myeloma (MM) Patients Using Bloodflow from the Spanish team in Pamplona. Using an immunomagnetic bead strategy, this new method indicates sensitivity with Next-Generation Flow (NGF) testing in blood at the level of 10-7 and 10-8 sensitivity.

Again, there will be much interest in the full details as well as the subsequent presentation, Abstract #866: Clinical Impact of Next Generation Flow in Bone Marrow Vs Qip-Mass Spectrometry in Peripheral Blood to Assess Minimal Residual Disease in Newly Diagnosed Multiple Myeloma Patients Receiving Maintenance As Part of the GEM2014MAIN Trial which deals with mass spectrometry testing for low levels of M-component in the blood.


Huge Number of Abstracts on Immune Therapies

Notable this year is the sizable number of oral and poster presentations on immune therapies including CAR T-cell therapies, bispecific antibodies, even trispecific ones.

For example, presentations on talquetamab include Abstract #157: Talquetamab, a G Protein-Coupled Receptor Family C Group 5 Member D x CD3 Bispecific Antibody, in Patients with Relapsed/Refractory Multiple Myeloma (RRMM): Phase 1/2 Results from MonumenTAL-1 and posters #1925, #1939, and #3243.

On the other hand, recently FDA-approved teclistamab is covered in Abstract #97: Teclistamab, a B-Cell Maturation Antigen (BCMA) x CD3 Bispecific Antibody, in Patients with Relapsed/Refractory Multiple Myeloma (RRMM): Correlative Analyses from MajesTEC 1; Abstract #160: Teclistamab in Combination with Subcutaneous Daratumumab and Lenalidomide in Patients with Multiple Myeloma: Results from One Cohort of MajesTEC-2, a Phase1b, Multicohort Study and in posters #1971, #3228, #3242, and #4558.
Abstracts on Carvykti™ include posters #1883, #1884, #2030, #2026, #2028, and #3354. 

Follow up on daratumumab will be discussed in Abstract #472: Health-Related Quality of Life for Frail Transplant-Ineligible Patients with Newly Diagnosed Multiple Myeloma Treated with Daratumumab, Lenalidomide and Dexamethasone: Subgroup Analysis of MAIA Trial and Abstract #473: Health-Related Quality of Life in Transplant-Eligible Patients with Newly Diagnosed Multiple Myeloma Treated with Daratumumab, Lenalidomide, Bortezomib, and Dexamethasone: Patient Reported Outcomes from GRIFFIN plus a large number of posters.

Among many pharma presentations are those related to selinexor (#4516); allo BCMA CAR-T (#1972); cevostamab (GPRC5D/CD3 bispecific) in abstracts #567 and #1924; Genmab 3014 (#3254) and Ichnos trispecific (BCMA/CD38/CD3) in abstracts #1342, #1442, and #2001 plus Harpoon 217—another trispecific with a poster scheduled for Sunday, December 11th.


Many Other Important Sessions

This year, it is impossible to come up with a simple Top 10! There are so many interesting abstracts in both oral and extensive poster sessions.

Basic and translational research, clinical and epidemiological studies, assessments of prognostic factors and novel therapies plus risk-adapted approaches are all featured. This rich menu of abstracts will lead to many new insights and advances in therapies to improve outcomes for myeloma patients.


The Bottom Line

This will be an intense ASH 2022, with much to listen to, review, and learn.

Heading into 2023, there will be a myeloma landscape with many features and an urgent need for ongoing education in order to be fully informed. Full updates will be provided and planned for The Best of ASH and the IMWG Conference Series webinars as well as interviews with numerous Key Opinion Leaders (KOLs) attending 2022 ASH.

Perspectives from patient Support Group Leaders (SGL) will also be provided.

Be ready for complete updates later in December!


Image of Dr. Brian G.M. DurieProfessor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is the Chairman of the Board and Chief Scientific Officer of the IMF. Dr. Durie is also the Chairman of the International Myeloma Working Group (IMWG)—a consortium of more than 250 myeloma experts from around the world—and leads the IMF’s Black Swan Research Initiative® (BSRI). 

 

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