June 14, 2014

European Hematology Association – 19th Annual Congress

The MMRF has been on-site at the European Hematology Association (EHA) Annual Meeting for the past few days. Much of the data presented were previously presented at the 2014 ASCO Meeting including results from trials involving exciting new treatments like daratumumab, SAR650984 and panobinostat, but several insights were notable.

Minimal Residual Disease
Dr. Joaquin Martinez-Lopez, University of Salamanca, presented data comparing next-generation sequencing (NGS) with flow cytometry and polymerase chain reaction (PCR) to measure minimal residual disease (MRD). Sequencing is like “fingerprinting” cells; there is high sensitivity and specificity, and millions of cells can be counted and analyzed. NGS will also not only identify all of the different myeloma clones within a patient but also will be able to determine the frequency of each clone. Dr. Martinez-Lopez concluded that the data underscored the promise of using NGS based MRD assessment, which is a useful method for patient risk stratification and can be used to determine molecular complete remission (CR) in myeloma. As part of the MMRF CoMMpassSM Study, the MMRF is working with Dr. Antonio Palumbo, University of Torino, and his team on a trial to definitively identify the best way to measure MRD.

Revised International Staging System
Dr. Stephania Oliva, University of Torino, presented proposed updates to the International Staging System (R-ISS). The revised criteria combine and sequence three prognostic factors (ISS status, cytogenetic status by Fluorescence in situ hybridization (FISH), and serum LDH levels), ie:

  • R-ISS Stage I (n=636, 27%): ISS stage I, no abnormal FISH result and low serum LDH
  • R-ISS Stage III (n=246, 11%): ISS stage III and HR Cytogenetics, or/and serum LDH high
  • R-ISS Stage II (n=1477, 62%): the rest

Correlation of R-ISS with survival:

Survival Endpoint R-ISS Stage I R-ISS Stage II R-ISS Stage III
5yr OS % 81 62 39
5yr PFS % 56 37 20
mPFS % 65 41 25

OS: Overall Survival
PFS: Progression Free Survival
mPFS: Median Progression Free Survival