Symposium Day Blog: But there’s more…

Jack Aiello |

The Friday before the official start of ASH is always considered Symposium day. However, even before Friday, there are typically more meetings of different groups. And even though this year’s 62nd American Society of Hematology (ASH) meeting is virtual, there’s no exception to pre-Symposium day meetings and I’ve attended three already.

The first was a meeting of the Global Myeloma Action Network (GMAN), founded by the IMF in 2013 with a goal to improve lives of myeloma patients around the world. GMAN is made up of myeloma advocates from different countries. We were treated to a preview of ASH highlights provided by Dr. Rafat Abanour in addition to discussing best practices among several countries as well as treatment barriers.

The second meeting was the International Myeloma Working Group (IMWG), which now consists of 255 distinguished myeloma doctors and researchers. Of these IMWG members, 227 participated in this virtual meeting. Their focus at this meeting (they also meet in June) was to discuss several important ASH abstracts, review publications plans for the past year, and discuss opportunities for the coming year that focus on providing treatment guidelines for doctors and patients. You can learn more about these at https://www.myeloma.org/imwg-publications.

And finally, the third meeting consisted of doctors and researchers belonging to the Blood and Marrow Transplant Clinical Trials Network (BMT CTN) Myeloma Intergroup. I’ve been to several of these meetings over the past years, and typically, we have a room of 75-100 attendees. However, this week’s virtual meeting had more than 1700 attendees who discussed presentations on Minimal/Measurable Residual Disease (MRD), Disease Immuno-biology, Next Generation Flow Cytometry-Sequencing-Mass Spectrometry, and Myeloma Cellular Therapy (CAR-T, Immune Profiling Responders/non-Responders, and Predictors of Durable Response).

Besides the fact that we are myeloma patients and caregivers, you should know that there are many smart doctors and researchers focused on developing better myeloma treatments and trying to answer many questions we have. In fact, that brings me to the three Symposium I attended today, each lasting two to three hours. In fact, they are all structured the same. They provide sample patient case studies and then debate questions on how best to treat that patient. Here’s a list of some of the debated questions:

  1. How to treat High-Risk Smoldering Myeloma?
  2. Approaches to induction, such as 3- or 4-drugs?
  3. Transplant or Not or Delay?
  4. Continuous Maintenance or Stop at MRD-?
  5. How to best treat the patient with Relapsed Disease at first and subsequent relapses?
  6. What’s the role of the various anti-BCMA therapies?

…and more.

And the esteem doctors debating these questions include Drs. Brian G.M. Durie, Ken Anderson, Sagar Lonial, Philippe Moreau, S. Vincent Rajkumar, Shaji Kumar, Suzanne, Lentzsch, USCF’s Tom Martin…it’s really quite amazing. For each of these questions, the audience of doctors are polled from a list of multiple-choice possibilities. Then the panel offers their answers (and generally don’t all agree). The two debaters present each side of the argument, followed by a panel discussion, and the audience is re-polled to see if minds were changed.

I think the most impactful statement I heard today came from Dr. Jesús San-Miguel, who, when discussing treating relapsed patients (and nearly all of us relapse), reminded us that there’s no best treatment solution for everyone. “Rather, we need a compass to find the best treatment for any patient and need to consider these fourpoints:

  1. Disease-related factors
  2. Patient-related factors
  3. Efficacy & toxicity of prior treatments
  4. Future options.

It reminded me that it’s so important for patients to have a myeloma expert as part of their treatment team and to get those 2nd and 3rd opinions from an expert who will consult with your local doctor.

That’s it for tonight. I still need to get ready for tomorrow’s first 7 a.m. meeting.

Be your own best patient advocate.

— Jack Aiello, on Twitter @JackMAiello

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