The Hematologist

January-February 2018, Volume 15, Issue 1

59th ASH Annual Meeting Wrap-up: Hotlanta Freezes Over

Saad Usmani, MD Director of Clinical Research in Hematologic Malignancies
Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC

Published on: January 10, 2018

Roughly two weeks have gone by since the 2017 ASH Annual Meeting, and I am halfway across the world in Pakistan to give talks at my alma mater, struggling through the embarrassment of riches to break down what made this meeting such a successful one.

Was it the quality content of the oral, scientific, and education sessions, the high-quality plenary abstracts, late-breaking abstracts (LBAs), or special sessions that offered something for every single niche and forte? How about the critical dissection of presented data and discussion of cost of care by my hematology peeps on Twitter? It could certainly have been the introduction of the “Global Capacity-Building Showcase,” which highlighted the efforts and research initiatives from a wide swath of low-to-middle-income countries. Perhaps, though, it may have been the Emory reception on Saturday night (I wasn’t invited though, so I can’t tell you). In actuality, the five days of the ASH annual meeting in Atlanta served as a perfect blend for hematologists from various areas of expertise and all levels of experience.

The plenary abstracts did not disappoint. We heard about the phase I safety and clinical activity data of BLU-285, a highly potent and KIT-specific oral inhibitor, in patients with systemic mastocytosis or relapsed and refractory myeloid malignancies. We were also reminded that efforts are underway to prevent and manage alloimmunization in sickle cell disease by way of customized induced pluripotent stems cells using CRISPR-Cas9 genome editing techniques to disrupt RHCE alleles. The ECHELON-1 trial, an open-label, randomized, multicenter, phase III study, compared standard-of-care ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) with brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine as frontline treatment for previously untreated advanced Hodgkin lymphoma patients, and met its primary endpoint (modified progression-free survival) in favor of the experimental arm. These data were debated vigorously throughout the meeting. Do we change our practice now? Are the neutropenia or neuropathy worth the progression-free survival (PFS) benefit or should we wait for longer follow-up? Then there was the fascinating presentation on high-throughput genomic sequencing to identify new pathogenic variants of gene mutations in patients with bleeding and platelet disorders. I might be biased, but all these stellar plenary presentations were well covered by my colleagues on the ASH News Daily editorial team.

The LBA session on Tuesday morning made sure we reach intellectual satiety before heading back home. The Hercules phase III trial made the case for the addition of caplacizumab (nanobody-blocking von Willebrand factor) to standard-of-care plasma exchange and steroids for thrombotic thrombocytopenic purpura (TTP). Use of caplacizumab resulted in decreased time to platelet response, reduced a composite outcome of TTP-related death, recurrence of TTP, or a major thromboembolic event. The Murano phase III trial compared venetoclax and rituximab (VR) versus standard immunochemotherapy with bendamustine and rituximab (BR) in patients with relapsed/refractory chronic lymphocytic leukemia, demonstrating superiority of VR (24-month PFS, 84.9% vs. 36.3%, respectively; HR, 0.19) and a benefit in overall survival (HR, 0.48; 95% CI, 0.25-0.90). The Alcyone phase III trial compared bortezomib, melphalan and prednisone (VMP) with daratumumab (anti-CD38 monoclonal antibody) and VMP in newly diagnosed transplant-ineligible patients. The trial met its primary endpoint in favor of daratumumab-VMP (median PFS not reached vs. 18.1 months; HR, 0.5) compared with VMP alone. The Hokusai VTE-Cancer Study randomized cancer patients with a venothromboembolic (VTE) event to receive either low-molecular-weight heparin (LMWH) or a direct oral anticoagulant edoxaban up to 12 months. This is the first study showing noninferiority of an oral anticoagulant to LMWH in treating cancer-associated VTE.

It was a pleasure serving as the Editor of ASH News Daily in 2017. For one, I was able to witness all the hard work and resources the ASH staff brought to bear in making the annual meeting take place seamlessly. And if you want a recap of the meeting, please check out the ASH News Daily articles online at www.hematology.org/ashnewsdaily. Next year, the ASH annual meeting returns to sunny San Diego, and I look forward to seeing you all there.

The Daily Needs New Blood! Want to get involved with the 2018 ASH News Daily as an Editor or Author? Email Managing Editor jllorens@hematology.org to learn how!

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