Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is a co-founder of the IMF and a member of the IMF Board of Directors.
The 65th ASH Annual Meeting and Exposition will take place from December 9-12 in San Diego, California and online.
With more than 7,000 accepted abstracts “representing the most cutting-edge science in hematology,” myeloma scientific content for this year’s ASH will be jampacked in sessions spanning three days—from Saturday, December 9th to Monday, December 11th.
It will be especially challenging for attendees this year to cover all important abstracts because of the number of sessions having overlapping schedules, with some running until 7:30 in the evening. I highly recommend using a teamwork approach to cover as many sessions as possible!
As per usual, Friday will be replete with scientific workshops and satellite symposia covering a range of topics: CAR T and bispecific treatment options, overcoming racial disparities in myeloma, clinical challenges, the impact of diet and nutrition, to name a few.
One of the biggest highlights this year is the plenary session which will be held on Sunday, December 10th, in the afternoon. Plenary Abstract #4 will reveal the results of the Phase 3 Randomized IsKia Clinical Trial, which compares KRd +/- isatuximab as a frontline therapy for transplant-eligible patients.
For the most part, the numerous abstracts will fall into five broad categories: treatment results; underlying myeloma disease biology; testing and monitoring (such as with MRD, genomics, immune testing, and mass spectrometry testing; 2023 hot topics (such as real-world data, drug access, and racial disparities); as well as what I would refer to as “clinical pearls”—smaller studies which may guide clinical decision-making.
Treatments
Treatment abstracts offer a wide range—including Phase 3 trials such as the GEM2017Fit Trial (Abstract #209) and the EMN20 Trial (Abstract #205) which evaluates KRd and IFM 2018-04 which assesses Dara-KRd as a quadruplet (Abstract #207).
Interestingly, Abstract #208 (Phase 2 EMN26 Study) evaluates the CELMoD, iberdomide as maintenance after ASCT in newly diagnosed multiple myeloma, which links to Abstract #4659 that assesses the impact in treatment for patients who are found negative of the surface marker GPRC5D—the basis for bispecific treatment efficacy with talquetamab (thus bispecific-resistant disease).
Abstracts #335 and #4686 focus on mezigdomide as an agent capable of reversing T cell exhaustion.
This year, quite a number of abstracts deal with the biology and treatment of high-risk smoldering multiple myeloma (HR SMM).
Treatments being assessed include everything—from Dara as a single agent in the Centaurus Trial (Abstract #210) to KRd in Abstract #339.
A considerable number of abstracts also deal with immune biology and the efficacy and toxicities of both CAR T cell products and bispecific plus trispecific antibodies. Twenty or more pharma or biotech companies present new and promising results which is extremely encouraging for patients.
Myeloma Biology
A whole series of abstracts encompass the biology of early disease, including both MGUS and smoldering multiple myeloma.
Abstract #339 is of particular importance, as it focuses on “measurable” residual disease to analyze the features of residual myeloma cells.
There are detailed assessments of immune dysfunction findings, genomics and transcriptional remodeling. Examples are Abstracts #88, #89, #643, #644, #757, #871, #872, and #880.
Testing for circulating myeloma cells is now being conducted by several groups. The Spanish team emphasizes the importance and “good” significance of peripheral blood testing being negative (Abstracts #646 and #3324) —a similar trend noted by the team from Greece (Abstract # 880).
Mass spectrometry testing is evaluated by a number of groups including the Spanish team in the HR SMM trial (Abstract #645) and mass spectrometry testing in another study (Abstract # 340).
A popular terminology at this year’s ASH is "multiomics" as a type of biologic assessment to encompass several elements, conducted by several groups. Abstracts #87, #88, #89, and #453 are some examples.
The hot topics of real-world data, inequities, and racial disparities will be covered in depth during the scientific sessions on Friday (December 8th) and the Spotlight Session on Sunday (December 10th) afternoon at 4:30 p.m., after the Plenary session.
Obviously, many individual abstracts also focus on these topics. There are many clinical pearls that guide clinical decision-making in several poster abstracts.
As an example, an initial report from the immune therapy registry (Abstract #3347) highlights efficacy and toxicity data with the bispecific agent teclistamab, which is also detailed in information from individual treatment centers globally.
Another helpful paper from the Asian Myeloma Network (Abstract # 1009) is the efficacy of the pomalidomide-cyclophosphamide-dexamethasone (PCD) combination versus pom-dex alone. This is a simple, well-tolerated all oral regimen.
The importance of 1q+ chromosomal abnormalities (as high-risk features) is again, noted in Abstracts #637 and #638.
Assessment of frailty in an ongoing or dynamic fashion is another helpful topic, with Abstract #342 as an example.
The Bottom Line
This year’s ASH will definitely be jampacked, with new and helpful information to be presented. Stay tuned, as we provide detailed updates followed by in-depth analyses post-ASH.
The investigators and others attending ASH will need to enjoy the Thanksgiving break and rest up to conserve their energy for what will definitely be a bustling few days in San Diego.
