What a year we have endured! 2020 will be one of the darkest years in history for the USA ,similar to the turmoil and strife of 1968, an unforgettable year those of us old enough to remember it. Actually, our comparator for “worst year” must go back further than 1968; however, to a time none of us remember: the pandemic of 1918. This year has been one of virtual meetings—no travel and minimal face-to-face contact. We are now near the end of 2020, time for the hematologic highlight of the year, ASH. Instead of warm welcoming San Diego, however, we will experience the 62nd Annual ASH Meeting and Exposition at our own homes. Like countless other medical meetings this year, ASH will be entirely virtual.
The IMF will bring ASH information to patients through the eyes and ears of other patients, a service it has provided for many years. We have lots of collective experience with virtual gatherings this year, but ASH is a challenge unlike all other meetings. Among the hundreds of abstracts, posters, oral presentations, plenary presentations, and satellite sessions are updates on myeloma. Our job is to find, analyze, and report them in understandable terminology. We will do this with blogs, Facebook posts, and tweets. Please follow all of us on Twitter @imfsupport @imfmikemyeloma @johnde1Myeloma @IMFjimMyeloma @jackMAiello @NorthTxMSG @LindaMyeloma @myelomahope @MyelomaTeacher @myelomavalarie @blondie1746 @IMFnurseMyeloma as the meeting progresses from satellite sessions on December 4 through final sessions on December 8.
Each of us has areas of special myeloma interest. As we progress through the ASH Annual Meeting I’d characterize mine as two areas……immunology and sequencing. We have made huge strides in myeloma treatment as we edge closer to cure. Treatment can bring many patients all the way to minimal residual disease-negativity (MRD-), meaning their remaining disease is almost completely undetectable by current techniques. We know, however, that myeloma lurks for months or even years before reappearing. Only our immune system can effectively control and monitor it long term. Our innate immunity can be augmented by T-Cell manipulation (CAR-T therapy). How can we improve depth and duration of response? What new improvements will be presented at ASH in the areas of mAb’s (monocloncal antibodies), ADC’s (Antibody Drug Conjugates), BiTEs (Bi-specific T-cell Engagers), and CAR-T therapies? How can we make our immune system become even more effective in killing myeloma?
In addition to these exciting evolving immunotherapies, we also have at least six different therapeutic classes: conventional chemotherapy, steroids, IMiDS, proteasome inhibitors, deacetylase inhibitors, and an XPO1 inhibitor. Combining these therapies results in many dozens of possible treatment combinations. How can they be used most efficiently together? How should these available treatments be sequenced, especially for relapsed myeloma patients? This is the art of medicine and the reason we need myeloma experts on our treatment team. As I experience the busy days of ASH, I will be looking for presentations outlining how to best utilize our various possible treatments (how to sequence them).
Virtual ASH will be a unique challenge for all of us. Please read our blogs, tweets, and posts and learn what is new as we share what we learn with you.
Jim Omel, Central Nebraska Myeloma Support Group