Friday was Satellite Symposia Day before the 65th American Society of Hematology Annual Meeting and Exposition (ASH). This day before the kick-off of the official #ASH23 meeting featured many industry-sponsored sessions that provide continuing medical education for healthcare professionals on various topics in hematology. One of the advantages of attending ASH virtually is that, while my in-person International Myeloma Foundation (IMF) blogging buddies were traveling to San Diego for ASH, the virtual half of our team was able to jump right in and participate in these satellite sessions.
I was able to attend several different sessions with my kitty, Miss Lili, on my lap. However, Miss Lili does not recommend trying to attend two sessions at one time as that really limited her lap space, not to mention my own ability to focus.
As I listened to talks throughout the day, I was continually amazed by the incredibly fast pace of therapeutic development in multiple myeloma. An evening session entitled, “Beyond the Guidelines, Clinical Investigator Perspectives on the Management of Multiple Myeloma,” was a whirlwind of information from clinical trials that is informing current treatment paradigms for patients. When I was diagnosed with multiple myeloma, three-drug regimens were the standard of care. Yet now, most of the newly diagnosed members in our support group are receiving four drugs at induction, with the addition of a CD38+ antibody, like Darzalex (daratumumab) added to deepen remissions.
This is my third year attending ASH, and in just that short amount of time, the FDA approval of several novel immunotherapies, like CAR T-cell therapies and bispecific antibodies, has led to a robust discussion on the optimal sequencing of lines of therapy and best practice for limiting toxicities and adverse side effects. This is a welcome shift that is providing new hope for myeloma patients. Indeed, in our own support group, before the approval of bispecific antibodies, we grieved the deaths of two of our members who were waiting for access to CAR T. Now, multiple myeloma specialists have more options, and they are beginning to tailor therapy treatments to the specifics an individual patient’s myeloma. As a multiple myeloma patient, listening to this satellite symposium session made me especially grateful for multiple myeloma specialists everywhere, who are extremely dedicated to caring for patients and overseeing myeloma clinical trials on new therapies and new combinations of therapies with the goal of finding a cure for myeloma.
I also attended a session entitled, “Untangling Amyloidosis,” which made me realize that the progress we’ve seen in multiple myeloma is informing how we treat other diseases as well, like amyloidosis. About 10-15% of multiple myeloma patients also have amyloid light-chain (AL) amyloidosis, where free light chains aggregate into amyloids at organs such as the heart and kidneys, leading to organ damage. AL amyloidosis is a devastating disease, which until recently had few options for treatment. I studied the process of protein folding and misfolding in the laboratory, so when a member of my faith community was diagnosed with AL amyloidosis over 15 years ago, our pastor asked me to speak to the family about what was ahead for them. I stayed up late into the evening for many nights, learning all I could about therapies in the pipeline, and it was devastating to realize that a cure would not happen in time to help this family. This experience though was really my very first opportunity to be a patient advocate, well before my own multiple myeloma diagnosis. After my stem cell transplant in 2017, I joined the LiveStrong program at the YMCA, and I met a gentleman who had just had a stem cell transplant to treat his AL amyloidosis. It was fun to compare transplant experiences and encourage each other as we built back our stamina.
During Friday afternoon’s session on “Untangling Amyloidosis,” I was thrilled to hear a talk by Dr. Giada Bianchi, MD, that illustrated all the progress in treatment options for AL amyloidosis over the past few years. Just like multiple myeloma patients, AL amyloidosis patients now receive a four-drug treatment regimen that includes Darzalex, which helps to lower the burden of circulating free light chains in the blood. In addition, several of the novel myeloma immunotherapies that have been approved for multiple myeloma are also being used to treat relapsed, refractory AL amyloidosis. For this protein folder, I’m especially excited to learn that there are also therapies under development that will target the protein aggregates that are ultimately responsible for organ damage. How wonderful to learn how multiple myeloma therapies are impacting patients with other diseases as well!
The fast pace of therapeutic development in multiple myeloma is very exciting to see! I was especially pleased though to see the focus throughout the day’s sessions on making sure all patients have access to these life-transforming therapies. Access to care and clinical trials was something that I heard addressed at every session I attended. In the morning satellite symposium, entitled “Overcoming Racial Disparities in Multiple Myeloma Outcomes and Clinical Trials: How We are Moving Care Forward Today,” Dr. Irene Ghobrial, MD, moderated the session, which contained talks by Dr. Omar Nadeem, MD, and Dr. Craig Emmitt Cole, MD, as well as a follow-up discussion session with questions from the audience. Community engagement and the commitment of academic centers are essential to eliminating disparities in myeloma care, and I got the sense throughout the day that this was a priority for everyone in the myeloma field. I especially appreciated the focus in this session on working together to ensure that future clinical trials increase the diversity of participants so that all patients can benefit from the many myeloma therapies in the pipeline.
I look forward to learning more about myeloma therapies in the pipeline when ASH officially kicks off on Saturday. I am very grateful to be part of the team of myeloma voices blogging at ASH for the International Myeloma Foundation. A huge thank you to our sponsors, Bristol Myers Squibb, Karyopharm Therapeutics, Janssen Pharmaceuticals/Johnson & Johnson Innovative Medicine, Regeneron Pharmaceuticals, and Takeda Oncology, who made this incredible experience possible! Bringing the myeloma patient perspective to ASH feels like another example of better living through science! 😊
— Jill Zitzewitz, PhD
Follow me on X @JillZitzewitz
Support Group Website: Central MA Multiple Myeloma Support Group