The annual ASH meeting is the most important event of the year for researchers in the field of hematology. With more than 30.000 health professionals attending the congress, it serves as the leading platform to present and discuss the latest research results as well as to meet up and discuss collaborative efforts. Some might also call it collective sleep deprivation, with meetings usually starting before sunrise and ending with PowerPoint-supported evening receptions.
Other than at the EHA congress, the ASH meeting unfortunately does not feature a patient advocacy track in the scientific programme – or at least free admission for patient advocates, which results in patient advocates only making up around 0,1% of the total audience. Roughly 35 patient advocates from all continents and across disease areas attended this 56th ASH congress in San Francisco. Amongst them, Giora Sharf and Jan Geissler are reporting some of the latest news on CML presented in presentations and on posters.
The state of play in CML at ASH 2014
Looking back on the past 15 years, since the introduction of Imatinib in first clinical trials, CML treatment has gone through a revolution. Research has turned CML from a deadly cancer into a chronic disease which, in most patients when diagnosed early, remains stable in the long term. Just in 2008 when ASH was held in San Francisco as well, we were all excited to see the early results of new 2nd generation drugs which were often the last hope, other than bone marrow transplant, for those patients that developed resistance against Imatinib or could not tolerate it. We were frightened that more and more patients would develop resistance and would run out of options.
Today, survival of patients with CML in chronic phase has become similar to that of the general population across all age groups: the high standard of CML therapy was evidenced by a presentation of the EUTOS project at ASH which aggregated data from clinical trials with Imatinib conducted by six different European CML study groups. Their aim was to understand the probabilities of dying of CML in comparison to death from any other cause. Compared in with the mortality rates of the general population, within a timeframe of 8 years, only 4% of patients died because they had CML, while 7% had passed away for causes unrelated to the leukemia. Every patient lost to CML is still one too many, but gladly this has become relatively rare.
Today we have five very effective and largely tolerable target therapies in CML. The 7-year data of Dasatinib and 6-year data on Nilotinib presented at ASH 2014 demonstrate increasing rates of good responses in patients, while we learn more about how to best handle co-morbidities and side effects. Hence, CML research largely focuses on optimizing CML treatment, on the prognostic importance of achieving the 10% BCR-ABL milestone in the first 3 months of treatment, on the conditions to consider treatment-free remission, on improving quality of life, on handling side effects and comorbidities, on increasing adherence – and eventually how to cure this chronic cancer.
This is why CML at ASH 2014 lacks breath-taking “breaking news” like those we had in earlier years. In a sense, these are good news, given where we are with CML treatment already. The next breaking news will hopefully be a medical cure for all CML patients, and it seems unfortunately this is still far away.
See our other detailed reports from ASH 2014:
- ASH 2014 Introduction: Optimizing CML therapy
- ASH 2014 Report #1: Stopping CML treatment for therapy-free remission
- ASH 2014: New data on Ponatinib – most potent, but overdosed?
- ASH 2014 Interviews on newest CML data, adherence and advocacy (Giora Sharf, Michael Mauro, Jan Geissler, Greg Stephens)
- ASH 2014 Report #3: Pediatric CML (soon to come)
Related ASH abstracts:
- Saturday poster #1801: Chronic Myeloid Leukemia in Chronic Phase: Survival in the Era of Tyrosine Kinase Inhibitors Is Similar to That of the General Population in All Age Groups
- Sunday presentation #153: Survival and Prognosis in Patients with First-Line Imatinib Treatment Under Particular Consideration of Death Due to Chronic Myeloid Leukemia
- Sunday presentation #152: Final Study Results of the Phase 3 Dasatinib Versus Imatinib in Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase (CML-CP) Trial (DASISION, CA180-056)
- Monday poster #4541: Efficacy and Safety of Nilotinib (NIL) vs Imatinib (IM) in Patients (pts) With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase (CML-CP): Long-Term Follow-Up (f/u) of ENESTnd
written by Giora Sharf and Jan Geissler