Blood Cancer News from ASCO 2013

Christine Wilson, cancer survivor, shares her experiences from the The American Society of Clinical Oncologists (ASCO) national conference in 2013. Every year,  cancer specialists and researchers from around the world gather to present their latest findings on the prevention, diagnosis and treatment of science. At a recent continuing medical education meeting, experts from the Abramson Cancer Center summarized some of the most important research from ASCO 2013 for a packed room of over 300 local oncologists.

This is a summary of the information presented at ASCO CME by Edward Stadtmaurer, MD, chief of hematologic malignancies at Penn Medicine.

One of the featured studies this year focused on the work done at Penn Medicine by Drs. David Porter and Carl June. That study used specially re-engineered CAR T cells to treat patients with relapsed ALL and CLL, all of whom had exhausted all other treatment options. Eighty percent of the first group of patients responded to this therapy and their responses have been prolonged.

Acute Myeloid Leukemia

• For acute pro-myelocytic leukemia, the combination of ATRA and ATO is the equivalent of standard chemotherapy. The response rate to this regimen was 100% suggesting that these patients can be treated without chemotherapy.
• Sorafenib vs. Azacytidine in AML with FLT3-ITD. The FLT3-ITD mutation is found in 20 to 25% of patients with AML and is associated with poor prognosis. This was a phase I/II study with patients who had been treated with several regimens and had multiple relapses. Forty-three percent of these patients attained either a complete or partial response, and a number are continuing to do well on a long term basis.

Chronic Myeloid Leukemia/ALL

• PACE: This phase II trial used ponatinib as a secondary TKI for patients with heavily pretreated CML. Fifty-six percent of patients responded, a very good result in these patients who have become resistant to therapy.
• Blinatumomab for relapsed/refractory ALL. This is a new agent that achieved a 69% response rate in a group of patients that is very difficult to treat successfully. A number of these patients were able to move on to allogeneic transplants.

Chronic Lymphocytic Leukemia

• Ibrutinib: This is a new drug that is generating significant excitement in treating CLL. In three different groups of patients at different stages of the disease, it has produced a high overall response rate that was not affected by known poor prognostic factors.
• Idelasib plus Rituximab/Bendamustine for relapsed/refractory CLL. Up to 90% of patients responded to this therapy with 60% having a two year progression free survival.

Multiple Myeloma

Treatments for multiple myeloma have improved significantly over the last decade. The focus now is on maintenance--on providing treatment that sustains initial complete responses.

• VMPT-VT vs. VMP: This study supports the value of maintenance therapy regardless of the primary treatment.
• Carfilzomib/lenalidomide/low dose dexamethasone in untreated myeloma. This study supports using new agents, such as carfilzomib earlier in the treatment process.
• Iaxomib plus lenalidomide and dexamethasone in untreated myeloma. These drugs, all oral agents, produced a 92% complete response rate.
• Carfilzomib/Pomalidomide/LoDex: This trial produced a 50% response rate in patients who had been heavily pre-treated, averaging six previous regimens. The one year survival rate was 90% with no neuropathy.

It is very hard for any patient or caregiver to evaluate whether and how these studies will apply to an individual case. The most important thing is to be in a place where your team can offer you the state of the art treatment options, and is providing leadership in developing tomorrow’s treatment.

For more information on these new approaches, and on the clinical trials currently underway at the Abramson Cancer Center, talk to your doctor or go to penncancer.org.