Everything, everywhere, all at once: the blockbuster brilliance of ASH 2023

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ASH 2023, VML Health

Everything, everywhere, all at once: the blockbuster brilliance of ASH 2023

By Susanne Bobadilla, VML Health

The sun just set on the American Society of Hematology’s 65th Annual Meeting in San Diego – its largest meeting ever, attracting 30,000+ attendees. The meeting showcased a field fizzing with energy, boasting incredible new therapies, practice-changing research and culture-shifting programs to end disparities in care. The ramifications are significant. Hematology, for so long associated with hard-to-treat diseases but limited options, is truly rewriting the script, with groundbreaking science bringing new hope for patients. ASH 2023 provided a blockbuster update on how innovation is reshaping all of hematology; everything, everywhere, all at once. Here’s our take on the highlights.

ASH equity; investments in DEI 

The importance of securing diverse perspectives across hematology was a consistent theme, with goals of combating inequities and increasing representation common denominators; everyone, everywhere, all at once. Blood cancer is the fourth most common malignancy, disproportionately effecting older adults (ages 65 and over) but also driving disparities among minority and underserved populations. Multiple myeloma (MM), for example, affects Black people two to three times more than white people, despite the genetic profile demonstrating fewer high-risk features. Delayed detection, poor access to treatments, and underrepresentation in clinical trials are major factors. ASH 2023 called out these inequities, highlighting efforts to address them – like Johnson & Johnson’s Call to Action Charter for MM – through collaboration across the entire ecosystem.

ASH also examined diversity within hematology. With Gen Z likely to represent 30 percent of the global workforce by 2030, debate focused on how the profession can attract tomorrow’s hematologists into a diverse, equitable and inclusive field, and how it can support historically excluded and marginalized groups through a career in hematology. 

The rise of OMICs

One of the most uplifting take-homes was the advancement of multi-omic precision medicine. Omics –  adopting integrative approaches aiming to understand the complex disease biology holistically as the sum of biological parameters  – is fueling the exploration of a multitude of biomarkers and indicators that allow treating clinicians to take the “whole patient” into consideration. Experts think it will change the paradigm of hematological practice and oncology overall. 

Its impact was evident everywhere, including examples in Burkitt lymphoma, acute lymphoblastic leukemia, and acute myeloid leukemia. According to at least one presentation, multi-omic data means we’ll be able to predict treatment responses in individual patients to find precision medicines for the rarest blood disorders. Just wow.

Treatment options expanding

The proliferation of treatment options and approaches in hematology stood out. Headlines included the first ever drug for hereditary hemorrhagic telangiectasia, an all-oral therapy for acute promyelocytic leukemia, and outstanding developments in hemophilia, pediatric hematology, thrombosis and across hematological malignancies.

Hematological oncology is expanding rapidly. A great example is MM, where one KOL reported there are now 92 possible combinations of fourth-line treatment options! With quad-based therapy tipped to become the standard of care for transplant eligible patients, bispecific antibodies improving real-world outcomes and CAR-T therapy set to extend progression-free survival, MM is becoming the poster child for advances in hematology.

Step change in sickle cell

The hottest news came in sickle cell disease (SCD), where exciting advances in gene therapy wowed KOLs and patients alike. Two new products, lovo-cel and exa-cel – which won FDA approval the day before ASH – nudge SCD closer to cure. In trials, 90.9 percent of lovo-cel patients experienced complete resolution of vaso-occlusive events, while 95 percent of exa-cel patients remained free from vaso-occlusive events at 12 months and beyond.

SCD disproportionately effects African Americans, bringing us back to the equity debate and challenges around access to medicines. Fortunately, ASH also trailed news of alternative approaches:

  • Haploidentical bone marrow transplant has a cure rate of 90% and is 10 times cheaper than gene therapy
  • Hydroxyurea has improved outcomes for children with sickle cell anemia in Africa, showing it’s possible to impact care in low-resource countries.

Celebrating science

Finally, ASH 2023 celebrated science in its purest form. Posters, presentations, and exhibition stands resisted overloading on immersive technology and stripped science back to the basics, with many using practical, patient-centered case studies – “if this was your patient, what would you do?” – to educate HCPs. Pictures of molecules and pathways were abundant, with communications returning to the long-lost art of showing doctors how drugs work. The approach is a throwback to the modern trend – “don’t show me how a drug works, show me that it works” – but likely reflects clinicians’ appetite to understand next generation treatments in a category overflowing with breakthrough innovation. It worked. HCPs engaged eagerly with content, recognizing ASH as a learning experience that could help them navigate the environment. It underlines the important role communications play in helping clinicians make next-step treatment decisions along increasingly complicated pathways.

Susanne Bobadilla, VML Health Susanne Bobadilla is EVP, global director medical strategy at VML Health.