Friday, November 3, 2023

ASH Abstracts (and Watching and Waiting)

 ASH Abstracts are here!

For those of you who are newer to this, ASH is the American Society of Hematology, a large group of blood disease specialists (including blood cancers like Follicular Lymphoma). Every year, they have a big meeting, usually in early December. This year it will be held December 9-12.

And about a month or so before the meeting, they release their abstracts -- the summaries of the presentations that researchers will make at the meeting. (The abstracts are available to view online.) The presentation might be about new research or clinical trial results (my favorite), or research that looks more closely at already available treatments (also very interesting), or research done on topics like survivorship, diet and exercise, or other topics related to blood cancers. 

I read as many of them as I can, and try to talk about some of the interesting ones here. 

I'm already getting emails about the research that will be presented. The makers of Yescarta (or Axi-cel), a CAR-T treatment, are planning to present a whole bunch of updated research results at ASH, according to a press release I got today.

My quick look at the abstracts tells me that there should be a whole lot of good things to share this year. I haven't looked deeply enough to know if there will be a game-changer for FL, but I'll keep my eyes open.

I'll share a quick one, though, that I found interesting -- abstract #4417: Time to Lymphoma Treatment within 24 Months in Watchful Waiting Follicular Lymphoma Defines Patients at High Risk for Progression: A Multicenter Analysis.

As someone who watched and waited (for 2 years, to the day!) before getting treatment, any research on W & W always catches my eye. This presentation looks at 411 FL patients diagnosed between 2008 and 2022, who watched and waited until they needed treatment. the researchers are interested in whether TLT (Time to Lymphoma Treatment -- the amount of time between diagnosis and treatment) affected survival outcomes.

They found that patients who needed treatment within 24 months of beginning watch and wait had lower 5 year Progression Free Survival. The 5 year PFS for the TLT24 group (as they are calling it) was 62.3%, while the 5 year PFS for those who didn't need treatment within 24 months was 89.5%. The researchers developed a model that uses clinical and laboratory factors to identify patients at high risk for TLT24, and recommend that those patients get early treatment instead of continuing to watch and wait.

This is one of those presentations that make we wish I had more information. My ears kind of perk up a little at this, given that the time period covered begins right when I was diagnosed (in January 2008) and includes information that involves me (I was TLT24 myself, apparently). Looking back, i am firmly in the 62.3% that had a good 5 year PFS. It makes me a little defensive.

But then I step back and put on scientist hat (remember, I'm not an actual scientist, so I have dress up like one). And I remember that statistics look at a large group of people reduced to numbers, not at individual patients. 

I'd still like to know more about the patients in the study, and how many of them had factors that put them at greater risk already. And I have to remind myself that this research is not a criticism of watching and waiting -- no one is saying that the W and W caused the problem (I do see research that seems to imply that every now and then).

No, it's a good thing -- an attempt to find out early on whether watching and waiting is a good option for people. If we knew that, it might help with the emotional decision that a lot of people have to make. I know very well what a weird thing it is to have a doctor say "You have cancer, but we're not actually going to treat it." Being able to say "Based o these factors, you're at a lower risk, so we can wait" might be a great thing. And so might, "Based on these factors, even though you're asymptomatic, we think you should get treatment now and potentially avoid problems later." It's one more factor to help patients make a decision.

So that was a good one right off the bat. I'm sure there will be some more interesting research to come.

Stay tuned.


1 comment:

Steve said...

We are still watching and waiting post treatment but I find it less stressful now.