ASH Annual Meeting 2018 round-up: part two
This week, the American Society of Hematology (ASH) Annual Meeting saw 30,000 experts gather in San Diego to discuss new research and clinical experience examining blood cancers and other blood disorders. In part two of our round-up, read about some of the results from the big blood cancer trials, and how we need to match individual treatments to individual people if we want to beat blood cancer.
If you missed part one of our round-up, read it here.
Big trials that will change how people with blood cancer are treated
New treatment combinations for CLL
We were excited to hear the latest results of the Bloodwise-funded CLARITY trial, presented by Professor Peter Hillmen (pictured above) from St James’ Hospital in Leeds. The new results build on the early findings, which show that combining two targeted drugs – ibrutinib and venetoclax – are a highly effective way to treat people with chronic lymphocytic leukaemia (CLL) who are not responding to current treatments.
After one year of treatment, CLARITY continues to impress, with every person continuing to respond to treatment. Because there was such a good response, some people could even stop their treatment and remained cancer free. Ibrutinib plus venetoclax will now be compared with other standard treatments in people with previously untreated CLL in a larger trial called FLAIR.
Professor Hillmen also gave an update on our IciCLLe trial, which suggests that adding another targeted drug called obinutuzumab to ibrutinib may boost the treatment response in people who have not been previously been given ibrutinib.
Reducing side effects of treatment for young people with aggressive lymphoma
Dr Viola Poeschel from Saarland University Medical School in Germany presented results from the FLYER trial, which was looking at reducing the amount of chemotherapy in nearly 600 young people with diffuse large B cell lymphoma (DLBCL). Standard treatment is 6 cycles of R-CHOP, but the trial found that 4 cycles were equally as good. This is excellent news as it means giving less treatment can reduce short term side effects, but also complications that can appear later, such as infertility and heart problems.
The future of personalised medicine
Although the concept of personalised medicine – matching the right treatments to the right patients – isn’t new, the tools to do this are still not optimal.
Impressive results from the BEAT AML trial
Results from the BEAT AML Master Clinical Trial were presented by Dr Amy Burd from the Leukemia and Lymphoma Society. The trial enrolled newly diagnosed people with acute myeloid leukaemia (AML) who are at least 60 years old, and it’s aim was to match a targeted drug according to each person’s AML within 7 days.
More than 350 people have been screened for this trial, and 95% of these have been assigned a new targeted therapy within 7 days. This rapid turnaround is incredibly important because AML develops quickly and needs treating immediately. Most people are given intense and toxic chemotherapy within hours of diagnosis, and this approach hasn’t changed for decades. Having a test that can quickly match better and kinder treatments to each individual person will have a major impact on the chances of people surviving, especially frailer people who are unable to tolerate intense chemotherapy.
Predicting how myelodysplastic syndromes (MDS) will behave
People with myelodysplastic syndromes (MDS) may be told they only have a few months to live after being diagnosed, and some may be well for decades. Although there are lots of scoring systems that can predict the course of MDS, some people can still be under or over treated because the system isn’t entirely perfect.
Dr Aziz Nazha from The Cleveland Clinic has developed a scoring system that uses ‘machine learning’, utilising artificial intelligence to automatically learn and improve from experience without being programmed. Using this approach, researchers analysed each person’s MDS, which turned out to be better than the standard scoring system. Dr Nazha hopes to build a website where clinicians can input data to find out their patient’s chances of survival which will not only help people with MDS dealing with the uncertainty of their cancer but will also help guide doctors with their treatment plans.
Do the bugs in our gut affect the success of stem cell transplants?
Dr Jonathan Peled from the Memorial Sloan Kettering Cancer has found the people undergoing a stem cell transplant may suffer more from complications if they have a lower diversity of harmless bacteria living in their gut before having a transplant. Dr Peled hopes that it might be possible manipulate the bugs in the gut before transplantation to help reduce complications such as graft versus host disease and infections.
We hope that you enjoyed our ASH round up. It certainly shows lots of hope on the horizon for people with blood cancer, and we look forward to what 2019 will bring.