The 2023 American Society of Hematology (ASH) Annual Meeting and Exposition had a record-breaking number of abstracts submitted and more than 7,400 were accepted. This includes a showcase of six late-breaking abstracts that have hematology experts buzzing. While this sounds incredible, it may also appear daunting when you want to know what all this information means for you or a loved one living with a blood cancer.
Patient Power spoke to Mikkael Sekeres, MD, chair of ASH’s committee on communications and chief of the division of hematology at Sylvester Comprehensive Cancer Center in Miami, to find out which highlights are particularly exciting. While presentations take place over several days in person and virtually from San Diego, December 9-12, below are a few highlights already being talked about by those in the know.
New Therapies, New Focus
In terms of the themes at ASH this year, Dr. Sekeres said: “We continue to see increasing amounts of interest in immunotherapy for hematologic malignancies, transplant and gene therapy for people with sickle cell disease, and an emphasis on vulnerable populations and their inclusion in clinical trials.”
AUGMENT-101
Dr. Sekeres stated that most patients with histone-lysine N-methyltransferase 2A (KMT2A)-rearranged acute leukemia have a particularly poor prognosis, and relapse is common after conventional therapy or hematopoietic stem cell transplant (HSCT). This is why, as a leukemia specialist, he is most excited about AUGMENT-101, a phase 2 clinical trial. The study investigated revumenib monotherapy in patients with this type of leukemia (relapsed or refractory). The topline efficacy and safety results will be presented at ASH.
The interaction of menins (a type of protein) with KMT2A fusion proteins drives the growth of leukemia. Revumenib is a menin inhibitor that blocks this interaction. In AUGMENT-101, 22.8% of patients had complete remission that lasted an average of 6.4 months.
“While revumenib is not yet approved by the FDA, I believe it will be an option in the future for patients with leukemia who have this mutation,” Dr. Sekeres said.
PERSEUS
Another study that has piqued experts’ interest is the PERSEUS trial. This phase 3 study may confirm a new standard of care for multiple myeloma, using four drugs (also known as quadruplet therapy). Patients with newly diagnosed multiple myeloma (NDMM) treated with daratumumab combined with bortezomib, lenalidomide, and dexamethasone (VRd) followed by maintenance therapy had higher rates of remission, depth of response, and a 58% improved progression-free survival (PFS) compared to patients treated with VRd without daratumumab.
The Power of Ibrutinib and Venetoclax
Dr. Sekeres also expressed great interest in two studies presented this year at ASH, both highlighting the power of the ibrutinib plus venetoclax combination, for two different types of cancer.
SYMPATICO
The multinational phase 3 SYMPATICO trial compared the efficacy and safety of combining ibrutinib and venetoclax with ibrutinib and placebo in patients with relapsed or refractory mantle cell lymphoma (MCL).
Ibrutinib is a Bruton tyrosine kinase (BTK) inhibitor and is already approved in multiple regions for treating MCL (if the patient has received more than one prior therapy). Venetoclax is a BCL-2 inhibitor and is approved in the U.S. for patients with chronic lymphocytic leukemia (CLL). These two drugs have complementary modes of action.
In the study, the powerful duo showed a statistically significant improvement in PFS, clinical remission and time-to-next-treatment. Dr. Sekeres sees this as a new standard of care for relapsed or refractory MCL.
The pairing of ibrutinib and venetoclax is also good news for patients with previously untreated CLL and has already proved to be more effective than chemoimmunotherapy.
FLAIR
The phase 3 FLAIR clinical trial showed that combining ibrutinib and venetoclax has superior results to FCR. It significantly improved PFS and overall survival (compared to FCR) and using minimal residual disease (MRD) can direct the duration of treatment (a highly personalized approach).
MRD looks at how many cancer cells are left in your body after treatment and is often used to determine what is best for the patient, such as increasing or decreasing the drug dose and extending or shortening the treatment period. Patients following this protocol with ibrutinib and venetoclax had a 97.2% PFS at three years.
There is more to come in the coming weeks on specific new drugs and new disease targets to be presented at ASH 2023. Stay tuned to Patient Power’s ASH Conference Coverage.