Highlights from ASCO 2012

According to me. I'm not a doctor, I'm an impatient patient, and pretty choosy about my highlights. They have to be about myeloma in some way, and should have the potential to affect my own myeloma journey.  Here are three:

• Carfilzomib and Pomalidomide continue to star: Carfilzomib is a new proteasome inhibitor, similar to Velcade, but without the neuropathy and with the ability to help some people for whom everything else has failed, including Velcade. Pomalidomide is a new immunomodulatory drug, like thalidomide and Revlimid, but with fewer side effects and with the ability to help some people for whom everything else has failed, including Revlimid and thalidomide. Studies also show that these two drugs together are amazing with newly-diagnosed patients. Both drugs are on track for possible FDA approval yet this year. Two more arrows in the quiver, possibly better than any of the other arrows.
  
  
• Elotuzumab: This strange duck is a monoclonal antibody, similar to the antibodies that our own body creates. It specifically seeks and destroys goofy plasm cells (myeloma cells). For some reason, though, it doesn't work by itself. It wants company. When added to Revlimid, it can often turn the disease around even in patients for whom Revlimid is failing. So far it has been used mostly with patients whose previous treatments have failed, but the work goes on.
  
  
• Zometa isn't so bad after all: The pendulum has clearly swung again, from Aredia (pamidronate) back to Zometa (zoledronic acid). Yes, it causes more osteonecrosis of the jaw (ONJ), in as many as 4% of patients compared with 1% for Aredia, but it has advantages: (1) The infusion time for Zometa is far shorter than the infusion time for Aredia; (2) Fewer infusions are needed; and (3) Most important, Zometa has an anti-myeloma effect of its own, and in a recent study people on Zometa actually lived longer than people on Aredia. So go for the Z, but get your dental work done first, and brush and floss like crazy.

For more, visit the other five posts from ASCO:

• ASCO Post # 1 Saturday morning, the Rajkumar tutorial - how to treat new patients.
• ASCO Post # 2 Sunday morning, the other really good myeloma stuff.
• ASCO Post # 3 More from Saturday morning.
• ASCO Post # 4 Monday, Immunotherapy.
• ASCO Post # 5 Monday, big myeloma poster session.

That's it from ASCO. We're riding the train home.

A new park along Chicago's Lakeshore Trail just south of McCormick Place, site of ASCO: