MCW Blood Cancer Experts Showcase the Latest Research at 65th Annual ASH Meeting

Drs Wu and DSouzaMCW blood cancer scientists joined the world’s largest hematology community to share the latest research advances and clinical updates at the 65th American Society of Hematology (ASH) Annual Meeting & Exposition, held December 9-12, 2023, in San Diego. Faculty, early-career researchers, and trainees from MCW’s hematology and oncology group had strong representation at the global event, co-authoring a total of 294 presentations that were shared through oral abstracts, poster talks, educational sessions, and scientific workshops.

Meera Mohan, MD, MS, FACP, assistant professor, Hematology and Oncology, presented three oral abstracts, including results from a study of teclistamab in patients with relapsed refractory multiple myeloma (RRMM). Teclistamab—a bispecific antibody drug targeting a protein called BCMA—was granted accelerated approval for use in RRMM by the Food and Drug Administration (FDA) in October 2022. In this multicenter study, investigators reported on the drug’s real-world use in 110 patients, 86% of which were triple-class refractory and 76% penta-refractory. Their results showed that teclistamab demonstrated promising efficacy, even in patients who had undergone multiple prior treatments and had a high level of resistance to different classes of medications.

“The overall response rate was 62%, ≥VGPR rate 51%, with comparable results in patients with and without prior BCMA-targeted therapies. At 3.5 months median follow-up, we estimated that the 3-month and 6-month progression-free survival rates were 57% and 52%, respectively. Overall, teclistamab is very efficacious in RRMM in a real-world setting,” said Dr. Mohan.

Dr. Mohan also noted that during the study, the cumulative risk of infection with the drug remained high, occurring in 40% of patients. However, to the team’s knowledge, this is the first study to show the protective effect of a therapy called intravenous immunoglobulin (IVIG) prophylaxis to reduce infections. “Our future studies will be geared toward understanding the risk factors for infection and potentially developing predictive scores,” she added.

Advancing Knowledge Across a Wide Spectrum of Blood Disorders

Mary Eapen, MBBS, DCh, MRCPI, MS, professor of Hematology and Oncology and Protocol Officer for the Blood and Marrow Transplant Clinical Trials Network (BMT CTN), shared long-term outcomes from the BMT CTN 0301 clinical trial, which aimed to optimize conditioning regimens for patients with severe aplastic anemia transplanted with marrow from HLA-compatible unrelated donors. Findings revealed the drug cyclophosphamide (Cy) at 50 mg/kg and 100 mg/kg doses were both effective for treating patients with unrelated bone marrow transplants. View the oral abstract.

Lynn Malec, MD, MSc, assistant professor, Pediatric Hematology and Oncology, gave insight into caregivers’ perspectives on the impact of hemophilia and their experiences with treatment—specifically with the drug efanesoctocog alfa. After conducting interviews with caregivers from the XTEND-Kids trial, investigators learned that efanesoctocog alfa prophylaxis provided improvements in both children and their caregiver’s daily life and functioning, and that caregivers preferred the drug to their child’s previous treatment. View the oral abstract.

Nirav Shah, MD, shared how scientists are improving the effectiveness of CAR-T therapy with a new adaptive manufacturing process that enriches CAR T-cells to target both CD20 and CD19 proteins. The approved CAR-T treatment for mantle cell lymphoma (MCL) only targets CD19, a limitation that can lead to a higher risk of recurrence and side effects like cytokine release syndrome and neurological issues. Results of this early-phase study revealed the dual-targeting approach is safe, feasible, and may help improve outcomes for patients with relapsed or refractory MCL. View the oral abstract.

Developing the Next Generation of Blood Cancer Scientists

James Wu, MD, MCW Medical School alumnus and current MCW Internal Medicine Resident Physician who is part of the MCW Physician Scientist Immersion Program (MCW-PSIP), was one of 13 resident physicians nationwide to receive the ASH HONORS Award, which provides funding support for talented medical students and residents to conduct hematology-related research projects, and to attend the annual ASH meeting. With support from his mentor, Anita D’Souza, MD, associate professor, Hematology and Oncology, and funding from the ASH HONORS Award and MCW-PSIP, Dr. Wu will investigate multiple myeloma (MM) health disparities with the goal of developing an intervention to help mitigate them.

“I developed a passion for combating health disparities in the Milwaukee community during medical school, and hope to pursue a career in healthy equity research within malignant hematology,” said Dr. Wu. “I’m excited to begin working towards this goal as the first future Hematology and Oncology physician-in-training to join MCW-PSIP, which will also provide two years of protected research time to focus on learning the fundamental pillars of and conducting health equity research.”

In his ASH abstract, Dr. Wu reported on more than 1,200 multiple myeloma (MM) consults conducted at the Froedtert & MCW Cancer Center from 2012-2022. Findings from the data showed that non-Hispanic White patients were significantly more likely to undergo autologous stem cell transplantation than non-Hispanic Black patients. Dr. Wu said he is excited about the next phase of this research, which will include qualitative interviews with MM patients and physicians to better understand transplant barriers and a geospatial analysis of Wisconsin’s MM incidence, transplant utilization, and mortality, with an additional focus on race/ethnicity and social vulnerability. “I am invigorated by James’ infectious enthusiasm and passion for hematology and cancer health disparities. I eagerly await to see his career blossom at MCW,” said Dr. D’Souza.

As someone who is just beginning his career as a physician-scientist, I could not think of a better mentor to have than Dr. D’Souza. Having a mentor and sponsor who believes in you can make all the difference in your career, and Dr. D’Souza believed in my passion and vision enough to take a chance on me. Without her support, I wouldn’t have been accepted into the MCW-PSIP or would’ve even applied for the ASH HONORS Award. She has taught me so much about the research process and, more importantly, how to conduct research with integrity,” said Dr. Wu.

 View the full list of MCW presentations on the ASH event website.