Imetelstat May Help Fill Unmet Needs in MDS Treatment

Commentary
Video

Amer Zeidan, MBBS, discusses the unmet needs that exist for myelodysplastic syndromes and how imetelstat may help fill these needs.

Amer Zeidan, MBBS, associate professor at Yale School of Medicine, highlights the ongoing unmet needs in treating myelodysplastic syndromes (MDS). While agents like luspatercept-aamt (Reblozyl) can initially reduce blood transfusion dependence, its efficacy weakens over time.

Here, Zeidan emphasizes the importance of developing new treatment strategies to help significantly improve treatment outcomes for patients with MDS.

Transcription:

0:09 | I think there still continues to be a need in this space because most patients, after some time, again, depending on how long they started on the drug, for example, the median duration of transfusion dependence with luspatercept in the the frontline setting is around 2 and a half years, and in the second-line setting it is around 38 weeks of continuous transition dependence with imetelstat, it is around 51 weeks. All of those patients, even when they respond, they will progress at 1 point and they need subsequent treatments. So I think using combinations of drugs, moving to the frontline setting, all of these are going to be important considerations. But also, developing drugs that not only improve transfusions, but can potentially lower progression to acute myeloid leukemia and improve overall survival, what we call disease modification. This is also important, and there could be hints that imetelstat does that, but we need more studies and longer follow up to fully understand this.

1:15 | I think the sequencing of treatments also needs to be better understood. For example, the IMerge study [NCT02598661], most of those patients have received the ESA in the frontline. But now, luspatercept is approved in the frontline and we don't fully understand the efficacy of imetelstat, after luspatercept, or of ESA after luspatercept, if luspatercept was used in the frontline setting. Understanding the impact of sequencing the combinations and trying to develop drugs that are disease modifying are the most important steps that are needed in the field.

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