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 ^[1] (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 ^[2] for patients with re­lapsed and re­frac­tory mul­ti­ple myeloma (abstract ^[3]).  Previous re­­sults from this study have shown that dara­tu­mu­mab is the first mono­clonal anti­body to have single-agent ac­­tiv­ity against myeloma (see re­lated Beacon ^[4] news).

In the same session, Dr. Shaji Kumar from the Mayo Clinic will present re­­sults from a Phase 1 study of ixazomib ^[5] (MLN9708) in re­lapsed and re­frac­tory myeloma patients that has com­pleted en­roll­ment (abstract ^[6]). 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 ^[7] news).

In addi­tion, during poster sessions on June 2 and 3, re­­sults from clin­i­cal stud­ies of elotuzumab ^[8], panobinostat ^[9] (Farydak ^[10]), and the newer drugs quisinostat ^[11] and TH-302 ^[12] will be pre­sented. There will also be a poster pre­sen­ta­tion on pre­clin­i­cal re­­sults for SL-401 ^[13].

In par­tic­u­lar, initial re­­sults will be pre­sented from a Phase 1b study of quisinostat in com­bi­na­tion with Velcade ^[14] (bor­tez­o­mib) and dexamethasone ^[15] (Decadron) for re­lapsed myeloma patients.  Preliminary re­­sults in­cluded in the poster’s abstract ^[16] 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 ^[17] (vorinostat) and panobinostat ^[9] 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 ^[18] 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 ^[19] (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 ^[20] 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 ^[21] (car­filz­o­mib) plus melphalan ^[22] (Alkeran) and prednisone ^[23] for older people newly diag­nosed with myeloma.  The abstract ^[24] 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 ^[25] (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 ^[26] (poma­lido­mide) plus low-dose dexa­meth­a­sone com­pared to high-dose dexa­meth­a­sone alone for re­lapsed and re­frac­tory myeloma patients (abstract ^[27]).  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 ^[28] 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 ^[29].  The re­­sults summarized in the pre­sen­ta­tion’s abstract ^[30] 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 ^[31],” 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 ^[32].”  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 ^[33].”  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 ^[34].”  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  ^[35]meeting website.

Beacon coverage of myeloma-related re­search pre­sented at recent scientific meetings can be found at these links: ASCO 2012 Meeting ^[36], EHA 2012 Meeting ^[37], ASH 2012 Meeting ^[38], and IMW 2013 ^[39].