Friday, June 4, was the first day of this year's American Society of Clinical Oncology (ASCO) annual meeting in Chicago. Most of the big multiple myeloma news of the day came out of a poster session in the afternoon.

At "poster sessions," researchers present a poster-sized summary of their research in a small, 2 meter by 1 meter cubicle. Researchers and physicians mill about, taking pictures of the posters with their cell phone cameras or taking notes. Sometimes one or more of the contributing researchers are present to answer questions. More often than not, however, there is nothing there but a mounted poster.

After a few hours, a poster discussion session is held in a large meeting room. About 400 people attended yesterday's session, which covered posters related to multiple myeloma, lym­phoma, and other hema­to­logic cancers.  The session was hosted by Dr. Nancy Bartlett of Washington University in St. Louis, and Dr. Robert Z. Orlowski of the MD Anderson Cancer Center in Houston.

Dr. Orlowski commented on a number of the myeloma-related posters. This was helpful, since it is hard to interpret results from early drug studies like these.

One study Dr. Orlowski commented on was a dose-escalation study of carfilzomib plus Revlimid (lena­lido­mide) and low-dose dexamethasone in re­lapsed/refractory multiple myeloma. Even though it might seem hard to get excited about such early results, Dr. Orlowski said "this combo looks attractive," and he sees real potential in this early research. (The Beacon covered this study in detail in an article published last night.)

A second poster Dr. Orlowski reviewed concerned the results of a Phase 1b clinical trial of oral panobinostat (Farydak, LBH589) in com­bi­na­tion with Revlimid and dexa­meth­a­sone. Once again, the patients in this study had re­lapsed or refractory multiple myeloma. Dr. Orlowski was not as positive about the results of this study. The reason: "Too many adverse side effects," most likely caused by the high doses of dexa­meth­a­sone.

In a follow-up interview, a representative from Novartis, the com­pany developing panobinostat, elaborated on the side effects observed during the study. She explained that "Europeans still use high dose dexa­meth­a­sone as the standard of care [and] in order to get the study approved, we needed to incorporate high dose dexa­meth­a­sone in the study." Unfortunately, "high dose dexa­meth­a­sone can be highly toxic and can cause many unwanted side effects."

A third study, which looked at results of a Phase 1 trial of Zolinza (vorinostat) com­bined with Revlimid and dexa­meth­a­sone in re­lapsed or refractory multiple myeloma patients, got a better review from Dr. Orlowski. He called the study "promising." Zolinza is a drug similar to panobinostat, and is already approved by the U.S. Food and Drug Administration as a treat­ment for cutaneous T-cell lym­phoma.

Another drug from Novartis was the subject of a fourth poster reviewed by Dr. Orlowski.  The drug has the codename RAD001, but the active ingredient in the drug -- everolimus -- is the same as in the drugs Zortress and Afinitor, which Novartis already markets to prevent kidney trans­plant rejection (Zortress) and to treat kidney cancer (Afinitor).  RAD001 was tested in com­bi­na­tion with Revlimid in re­lapsed or refractory myeloma patients.  Dr. Orlowski described the results as "mixed," given the neu­tro­penia and periph­eral neu­rop­athy observed in the trial participants.

The last poster discussed by Dr. Orlowski was a University of Arkansas for Medical Sciences study comparing out­comes of the Total Therapy 3 and Total Therapy 2 regi­mens.  The study's objective was to isolate specific genes that might determine which com­bi­na­tions of novel ther­apy agents work best in specific patients.  Dr. Orlowski's take on the results of the study were that adding Velcade (bor­tez­o­mib) to most anti-myeloma drug com­bi­na­tions helped some high risk patients in the study.  Most other com­bi­na­tions have little or no impact.

Dr. Orlowski concluded the multiple myeloma-related portion of the poster discussion session this way: "Can we personalize myeloma ther­apy yet?"  Dr. Orlowski answered his own question: "No."  But adding Velcade may help until we can identify which patients will respond best to which drug com­bi­na­tions.

Note: For an early look at the highlights from Day Two of the ASCO 2010 meeting, see this posting thread in the Myeloma Beacon forums.