ASCO 2012 - Blog Post # 3

Yesterday (Saturday), Dr Rajkumar from Mayo Clinic presented a tutorial on the treatment of newly-diagnosed myeloma patients. Here are a few more interesting nuggets from that day's presentations and poster sessions:

Transplant Eligibility:

Would you transplant this man? Clint Eastwood is 82 now, but Dr Amrita Krishnan thought perhaps he might nevertheless be a candidate for transplant. Her point was that numerical age is not itself a factor. Rather, the physical issues ("comorbidities") that often come with age are factors, by themselves, including kidneys, heart, liver, and other diseases such as diabetes.

Pomalidomide and Dex with Clarithromycin:

Clarithromycin (Biaxin) is an antibiotic, available by prescription since the 1970s. Since at least 2001, researchers have known that it has an anti-myeloma effect when added to dexamethasone or other standard myemoma therapies. In this study, Dr Adriana C. Rossi demonstrated a significant and sustained response to this 3-drug combination in heavily pretreated patients, better than pomalidomide/dex without clarithromycin.

Baseline Sensory Deficits Predicting Neuropathy in Treatment:

Dr Elisabeth G. Vichaya measured patients' sensory detection before treatment with chemotherapy, and compared that with the neuropathy that patients experienced in chemotherapy. She found:

• Patients who were initially less able to detect sharpness (e.g. a pin) experienced LESS pain and numbness than others;
• Patients who were initially less able to detect warmth experienced MORE pain and numbness; and
• Those with lower initial skin temperatures also experienced MORE pain and numbness.

She thought perhaps that information could be a factor in helping doctors choose the best therapy for a patient.