Every year, scientists, physicians, and clinical researchers converge at conferences around the world to share and debate the most promising advances in cancer care.  Experts present data from ongoing research, the results of clinical trials and new insights. The most important new findings related to blood and blood cancers are presented annually at the American Society of Hematology (ASH) conference.

The 60^th annual ASH meeting, held December 2018 in San Diego, contained a wealth of scientific results changing how physicians care for patients with blood or related cancers.  The results of several clinical trials presented showed that new medicines targeting specific abnormalities within specific cancer types are better at controlling the growth of cancer than some currently used treatments.  The  trials showed that for patients with some cancers arising in the blood (known as leukemias or myeloma) or lymph system (lymphomas), some of these new ‘targeted therapies’ could be used alone or in combination with medicines currently in use for improved outcomes.  The improved outcomes included increased cure rates; longer lasting remissions; and better quality of life.  There were exciting results presented for a new treatment for patients with a blood disorder that results from a failing bone marrow that is sometimes a precursor to cancer, myelodysplastic syndrome.  This disease can be very difficult to treat; making the ASH report of a new therapy a source of hope for those who suffer from this condition.

Much of the research presented at ASH focused on ways to better group blood related cancers such that doctors can better understand cancer behavior and response to treatment.  Traditionally, cancers have been grouped by appearance:  If cancer cells look like blood cells they are grouped as ‘leukemias’; if they look like lung cells they are grouped as ‘lung cancer’.  But, increasingly, doctors and scientists understand that grouping cancers by appearance alone does not give us the best understanding of how cancers behave. 

Research shows that certain changes within cancer cells better predict the aggressiveness – and consequent behavior - of a cancer.  Furthermore, these changes also predict whether a cancer is likely to respond to a particular treatment.  Doctors can fine tune the selection of treatment(s) for individual patient’s based on these changes. The ASH conference provided good news for some patients with a type of lymphoma called Diffuse Large B Cell.  Some patients, whose lymphoma has characteristics suggesting relatively non-aggressive behavior, may require only 4 cycles of chemotherapy; compared with the current recommendation for 6 cycles of treatment.  Thus, many patients may be spared the side effects and expenses of longer treatment and possibly speed recovery. 

The information presented at ASH, together with other medical advances, offer promise for better treatments and methods to tailor treatment to individual patients’ cancer as well as ways to reduce side effects of cancer therapy.  It is truly an exciting time for cancer research.

This column was co-authored by Linda M. Sutton, M.D., medical director, Duke Cancer Network and associate professor of Medicine at Duke University Health Center and Ivy Altomare, M.D., assistant medical director, Duke Cancer Network, and associate professor of medicine, Duke University Health System.