The American Society of Clinical Oncology will hold its 49^th annual meeting May 31 through June 4 in Chicago.

Similar to pre­vi­ous years, more than 25,000 clin­i­cal spe­cialists from all over the world are ex­pec­ted to attend the five-day meeting to discuss the cur­rent re­search in cancer treat­ment and care. The theme for this year’s meeting is “Building Bridges to Conquer Cancer.”

During the meeting, there will be pre­sen­ta­tions and seminars about all areas of cancer, in­clud­ing many focused spe­cif­i­cally on mul­ti­ple myeloma. The ASCO website cur­rently lists more than 60 myeloma-based pre­sen­ta­tions (included under “lymphoma and plasma cell disorders”).

The ASCO meeting is one of three annual scientific meetings where im­por­tant new myeloma-related re­search findings are reported. The other two key conferences are the annual meetings of the American Society of He­ma­tol­ogy (ASH) and the Euro­pean He­ma­tol­ogy Asso­ci­a­tion (EHA).  The Inter­na­tional Myeloma Workshop, which meets every other year and is focused solely on mul­ti­ple myeloma, was also held earlier this year.

As in pre­vi­ous years, The Myeloma Beacon will be cover­ing the ASCO 2013 meeting in detail.  Readers can ex­pec­t many articles during and after the meeting about the key myeloma findings.

Organization Of The Meeting

Research findings pre­sented at ASCO and other scientific meetings are generally com­mu­ni­cated in either oral pre­sen­ta­tions or poster summaries.

Oral pre­sen­ta­tions are usually given for re­search that is con­sidered par­tic­u­larly im­por­tant, either because the subject itself is im­por­tant or the re­­sults are based on sub­stan­tial amounts of evi­dence (for example, a sizable clin­i­cal trial).

Poster re­search summaries are made avail­able during spe­cif­ic “poster sessions,” when re­searchers dis­play summaries of their stud­ies on posters in a large exhibition hall.

Compared to the re­search summarized during oral pre­sen­ta­tions, the findings in poster summaries generally are in earlier stages of devel­op­ment and may in­volve only laboratory re­search or clin­i­cal trials with just a small num­ber of patients.

Abstracts for all ASCO pre­sen­ta­tions are now avail­able.  However, the re­­sults in­cluded in the abstracts are fre­quently pre­lim­i­nary re­­sults that will be up­dated at the meeting.  We there­fore provide below brief overviews of the most im­por­tant myeloma-related stud­ies that will be pre­sented at the meeting.  During and after ASCO, we will provide more in-depth summaries of these stud­ies that in­clude the up­dated data pre­sented during the meeting.

Treatments Under De­vel­op­ment

Several of this year’s ASCO pre­sen­ta­tions will unveil up­dated re­­sults from Phase 1 and Phase 2 clin­i­cal trials of poten­tial new drugs under devel­op­ment for the treat­ment of mul­ti­ple myeloma.

On June 3, Dr. Henk Lokhorst from UMC Utrecht in the Netherlands will present up­dated re­­sults from a Phase 1/2 study eval­u­ating the safety and ef­fi­cacy of daratumumab for patients with re­lapsed and re­frac­tory mul­ti­ple myeloma (abstract).  Previous re­­sults from this study have shown that dara­tu­mu­mab is the first mono­clonal anti­body to have single-agent ac­­tiv­ity against myeloma (see re­lated Beacon news).

In the same session, Dr. Shaji Kumar from the Mayo Clinic will present re­­sults from a Phase 1 study of ixazomib (MLN9708) in re­lapsed and re­frac­tory myeloma patients that has com­pleted en­roll­ment (abstract). Previous re­­sults from this study and other ix­az­o­mib stud­ies have shown that ix­az­o­mib, alone or in com­bi­na­tion with other myeloma drugs, appears to be ef­fec­tive in newly diag­nosed as well as re­lapsed and re­frac­tory myeloma patients (see re­lated Beacon news).

In addi­tion, during poster sessions on June 2 and 3, re­­sults from clin­i­cal stud­ies of elotuzumab, panobinostat (Farydak), and the newer drugs quisinostat and TH-302 will be pre­sented. There will also be a poster pre­sen­ta­tion on pre­clin­i­cal re­­sults for SL-401.

In par­tic­u­lar, initial re­­sults will be pre­sented from a Phase 1b study of quisinostat in com­bi­na­tion with Velcade (bor­tez­o­mib) and dexamethasone (Decadron) for re­lapsed myeloma patients.  Preliminary re­­sults in­cluded in the poster’s abstract in­di­cate that the com­bi­na­tion is tol­er­able and active, with an over­all re­sponse rate of 88 per­cent in patients treated with a median of two prior lines of ther­apy.  Quisinostat is being devel­oped by Janssen Re­search & De­vel­op­ment, a Johnson & Johnson (NYSE: JNJ) sub­sid­i­ary; it is an oral histone deacetylase in­hib­i­tor, which works by in­creas­ing the pro­duc­tion of pro­teins that slow cell division and cause cell death.  Zolinza (vorinostat) and panobinostat belong to the same class of drugs and are also being studied in com­bi­na­tion with Velcade and dexa­meth­a­sone for the treat­ment of myeloma.

Initial re­­sults from a Phase 1 study of TH-302 plus dexa­meth­a­sone in heavily pre­treated myeloma patients will also be pre­sented during the poster session.  Preliminary re­­sults in the poster’s abstract show an over­all re­sponse rate of 22 per­cent in patients treated with a median of six prior lines of ther­apy.  The lower doses tested appear safe, but the highest dose was asso­ci­ated with severe side effects.  Velcade will be added to the com­bi­na­tion for Phase 2 of the study.  TH-302 is being devel­oped by Threshold Pharma­ceu­ticals (NASDAQ: THLD) and the German pharma­ceu­tical com­pany Merck KGaA. TH-302 is a drug that is activated under low oxygen level con­di­tions, which are common in tumors and the bone mar­row of people with blood cancers. It is cur­rently also being in­ves­ti­gated in a range of solid tumors.

Additional Re­search Highlights

During the oral pre­sen­ta­tion session on June 3, re­­sults from sev­er­al other im­por­tant myeloma stud­ies will be pre­sented.

First, Dr. Mario Boccadoro from the Uni­ver­sity of Turino in Italy will present re­­sults from a study that compares mel­phalan-prednisone-Revlimid (lena­lido­mide) (MPR) treat­ment with tandem (two back-to-back) stem cell trans­plan­ta­tion.  It also eval­u­ates the ben­e­fit of Revlimid main­te­nance ther­apy fol­low­ing either of these pre­vi­ous treat­ment ap­proaches.  According to the abstract for Dr. Boccadoro’s pre­sen­ta­tion, stem cell trans­plan­ta­tion sig­nif­i­cantly pro­longs pro­gres­sion-free sur­vival com­pared to MPR.  Likewise, the re­­sults show that Revlimid main­te­nance ther­apy sig­nif­i­cantly pro­longs pro­gres­sion-free sur­vival, re­gard­less of initial treat­ment, with a trend to­ward im­prov­ing over­all sur­vival.

Then, Dr. Cyrille Touzeau from the Uni­ver­sity Hospital in Nantes, France, will present initial re­­sults from a Phase 1/2 study of Kyprolis (car­filz­o­mib) plus melphalan (Alkeran) and prednisone for older people newly diag­nosed with myeloma.  The abstract for Dr. Touzeau’s pre­sen­ta­tion states that initial re­­sults from the study compare favorably to those for Revlimid-dexamethasone as well as other com­bi­na­tions of mel­phalan and pred­ni­sone plus a novel agent, such as thalidomide (Thalomid) (MPT), Velcade (VMP), or Revlimid (MPR).

Dr. Jesús San-Miguel from the Uni­ver­sity Hospital in Salamanca, Spain, will also present up­dated re­­sults from a Phase 3 study of Pomalyst (poma­lido­mide) plus low-dose dexa­meth­a­sone com­pared to high-dose dexa­meth­a­sone alone for re­lapsed and re­frac­tory myeloma patients (abstract).  Interim re­­sults from the study have already shown that the Pomalyst com­bi­na­tion extends pro­gres­sion-free and over­all sur­vival com­pared to dexa­meth­a­sone alone (see re­lated Beacon news).

During another talk, Dr. Antonio Palumbo from the Uni­ver­sity of Turino in Italy will present re­­sults from a meta-analysis that in­ves­ti­gates the im­pact Revlimid has on the like­li­hood of devel­op­ing a second cancer.  The re­­sults summarized in the pre­sen­ta­tion’s abstract show that sec­ond blood cancers are more common among people treated with Revlimid, but the abstract states that the in­creased risk is lim­ited to patients treated with Revlimid plus mel­phalan, not either drug alone.

Advances In Diagnostics And Man­age­ment Of Myeloma

During an education session on June 1, myeloma experts will discuss sev­er­al im­por­tant topics re­lated to diagnosing and managing mul­ti­ple myeloma.

The first pre­sen­ta­tion will be given by Dr. Donna Reece from the Princess Margaret Hospital in Toronto.  In her talk titled “Update on the Initial Therapy of Multiple Myeloma,” she will discuss how the use of novel agents has im­proved the treat­ment of newly diag­nosed mul­ti­ple myeloma.

Dr. Robert Orlowski from the MD Anderson Cancer Center will give the sec­ond pre­sen­ta­tion, which is titled “Novel Approaches to Treatment of Double-Refractory Multiple Myeloma.”  He will discuss novel agents under clin­i­cal devel­op­ment that have shown ac­­tiv­ity in myeloma that is resistant to a pro­te­a­some in­hib­i­tor, such as Velcade, as well as an immuno­modu­la­tory drug, such as thalido­mide and Revlimid.

Finally, Dr. San-Miguel will give a talk titled “New Tools for Diagnosis and Monitoring of Multiple Myeloma.”  In his pre­sen­ta­tion, he will discuss the techniques used to eval­u­ate myeloma patients, in­clud­ing how each test can be used to diagnose myeloma and de­ter­mine a prog­nosis for patients as well as any drawbacks of each test.

There will also be an education session on June 4, where experts will discuss how to treat sev­er­al types of blood cancers.

The first pre­sen­ta­tion will be given by Dr. Palumbo and will be titled “How I Treat Elderly Patients with Multiple Myeloma.”  He will discuss the criteria for determining whether an older patient is a stem cell trans­plant can­di­date as well as treat­ment regi­mens that are op­tions for those who are not trans­plant can­di­dates.

For more in­­for­ma­tion on ASCO’s 49^th Annual Meeting, in­clud­ing the final pre­sen­ta­tion schedule, abstracts, and in­­for­ma­tion on attending, please see the American Society of Clinical Oncology meeting website.

Beacon coverage of myeloma-related re­search pre­sented at recent scientific meetings can be found at these links: ASCO 2012 Meeting, EHA 2012 Meeting, ASH 2012 Meeting, and IMW 2013.