Reproduced from Oncology Frontier
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| Dr. Huang talks with Dr. Sonneveld at EHA 2015 |
Oncology Frontier《肿瘤瞭望》: What are the progresses or differences of EHA 2015 compared to last ones.
Dr. Sonneveld： In terms of Multiple Myeloma, which is my expertise.
We have seen presentations concerning three very active and promising drugs in
the relapse and refractory setting.
One is Carfilzomib which was presented and
published recently as the ASPIRE trial which combines Carfilzomib with Lenalidomide
and Dexamethasone compared to Lenalidomide and Dexamethasone alone.
This results in a significantly better
progression-free survival, 26 months versus 17 months in favor of the triple
combination. We are now seeing other combinations with Carfilzomib.
It is not yet approved in Europe but has been
approved in the United States. It will be approved in Europe in the near future
and will probably change the standard of care in relapsed and refractory
patients.
The second drug is Elotuzumab. This is an
antibody against SLAMF7， which is an epitope on the
membrane of myeloma cells. The ELOQUENT-2 study presented shows that Elotuzumab,
again in combination with Lenalidomide and Dexamethasone，
also leads to better progression-free survival.
The third one is Daratumumab, an antibody
directed against CD38. CD38 is an important epitope on the membrane of myeloma
cells.
This drug has single-agent activity in
relapsed and refractory patients with about 50-60% PR and 10-50% CR. There are
more trials ongoing and we will hear more about that in coming years.
So for myeloma, things are progressing and
developing with some interesting results and new data.
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Pieter Sonneveld, MD Ph D Professor
Head, Department of Hematology, Erasmus MC. President Elect, European Hematology Association Chairman, European Myeloma Network (EMN) |
Dr. Huang: I have attended EHA several times and my
feeling is that the conference is increasingly international.
My field is transplantation and the education
program does not have much about alternative transplantation and relapse prediction
and management after Autologous Transplantation.
This is a field that the program maybe needs
to pay more attention to. I would also add that even though it is an
increasingly international conference, the speakers are almost all from Europe.
Certainly in the field of relapse prediction and management, for example and
alternative transplantation, I think the European experts are not really
familiar with the data.
Input from experts, not only from Europe, but also
more from the United States and Asia would be vital for the EHA program in the
future.
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| XiaoJun Huang, MD Professor Head, Hematology Department People's Hospital of Beijing University President, Hematology Research Institute of Beijing Uni. Chair, China Society of Hematology |
Dr. Sonneveld：We have almost 10000 attendees at this
conference from all over the world.
This will change with time. Of the submitted
abstracts, the most were from Italy, then the United States. There were very
good numbers from China, Korea and Turkey.
So things will change as we become more
international.
In the new novel agents era, what do you think the use of HSCT in the treatment of Myeloma? Would you prefer it in the early or delaying it to later?
Dr. Sonneveld: Right now in Europe, Autologous Transplantation is a standard
part of first-line treatment in myeloma.
Many people claim that you can delay Autologous
Transplantation until first relapse because it is also effective at that time.
But if we look at the data, there is not a lot of evidence supporting that. If
you apply Autologous Transplantation in first-line treatment, the median
progression-free survival is around 45 months.
If you apply transplant at relapse, as has
been demonstrated by the British group, progression-free survival is 19 months.
There is quite a difference. We think that such an effective treatment should
be applied as first-line.
There are two ongoing trials that are looking
at this question. Patients are randomized to receive Autologous transplantation
as part of first-line treatment or at first relapse and we will find out those
results in the future.
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| EHA 2015 venue entrance |
Dr. Huang: So transplantation will remain first-line therapy for Multiple Myeloma
even in the era of novel agents. But there are alternatives and more data is
required for any changes to occur.
In China, Autologous Transplantation is
first-line therapy for Multiple Myeloma also as we don't have much access to
the new agents.
Dr. Sonneveld: In addition, we cannot cure myeloma, so why not use an effective
treatment.
We can better use Autologous Transplantation
plus the novel agents in combination for induction or consolidation therapy and
try to improve response rates. In the process, hopefully, we can cure some
patients.
Any collaboration and exchange educational program between Chinese Society of Hematology(CSH) and European Hematology Association(EHA) in the future?
Dr. Huang: Of course.
Two years ago, EHA and the Chinese Society of Hematology
(CSH) commenced an official cooperation program. What we need to do is
strengthen our cooperation and add new programs such as personnel exchanges or
clinical trials. We are already moving in the right direction.
Dr. Sonneveld：I would be very much in favor of doing that.
The Board of EHA have discussed an outreach program with other countries
including China and I don't think it will be long before we do make concrete
plans to proceed maybe in the area of cooperative trials.
China is certainly able to contribute large
numbers of patients to trials so the idea is very attractive both for EHA and
for China.
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