Clinical Implications of Recent Data in MDS

Opinion
Video

Gary J. Schiller, MD, concludes with thoughts on the clinical implications of recent data presented at ASH 2023 on the myelodysplastic syndrome treatment landscape.

This is a video synopsis of a discussion featuring Gary J. Schiller, MD, chief of the Hematological Malignancy/Stem Cell Transplantation program at the David Geffen School of Medicine at UCLA Health Jonsson Comprehensive Cancer Center.

Based on ASH presentations and literature, luspatercept offers advantages over erythropoiesis-stimulating agents (ESAs) for lower risk, transfusion-dependent MDS and symptomatic anemia, with higher response rates. For ESA-refractory patients, the telomerase inhibitor imetelstat induces transfusion independence in a minority but significantly more than placebo. This correlates with improved symptoms per quality-of-life scores.

However, it is unclear if imetelstat improves symptoms without directly alleviating anemia. Since inflammatory biomarker data from the phase 3 IMerge trial was not presented, effects attributable to decreased inflammation are speculative.

Early trials targeting the inflammasome to reduce inflammation integral to MDS and impaired erythropoiesis show promise. The anti-inflammatory agent canakinumab decreased a biomarker of inflammation but clinical responses are not yet seen. Further inflammation-directed trials are awaited to determine if targeting this pathway can improve anemia and related symptoms in lower risk MDS.

*Video synopsis is AI-generated and reviewed by Targeted Oncology editorial staff.

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