Highlights in MDS at ASH 2022: treating lower-risk & higher-risk disease, trial updates, & more
Dec 21, 2022
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Doctors David Sallman and Andrew Brunner discuss updates in myelodysplastic syndromes at ASH 2022. Topics include treatment options for lower-risk and higher-risk disease, trial updates, novel classification systems, and therapies after failure to hypomethylating agents.
Therapies like luspatercept and metal stats show promise in treating lower-risk myelodysplastic syndrome (MDS) and may challenge traditional management approaches.
Four large phase three randomized trials may offer new agents and redefine high-risk MDS, incorporating molecular diagnostics for better prognostication and treatment approaches.
Deep dives
Key Updates in Lower Risk MDS
The podcast discusses key updates in lower risk myelodysplastic syndrome (MDS). The experts mention the use of therapies like luspatercept and the promising data on the long-term responders with a metal stat. They also raise questions about the Cintra Rev trial, which challenges the typical management of lower risk MDS by introducing preemptive therapy. The experts acknowledge the need for disease modification in lower risk MDS and highlight ongoing trials with Kenna Kinumab, an interleukin one beta inhibitor, and explore the potential of lower schedules of hypomethylating agents as treatment options.
Insights into Higher Risk MDS
The podcast delves into the challenges of higher risk myelodysplastic syndrome (MDS) and the hope for future treatments. The experts eagerly await the results of four large phase three randomized trials that may offer new agents for higher risk MDS. They discuss the redefining of high-risk disease and the incorporation of molecular diagnostics in classification systems to better prognosticate patients. The experts reflect on the evolving interpretations of treatment approaches based on risk stratification and the potential for refining classifications to improve patient outcomes.
Addressing HMA Failure in MDS
The podcast explores the limited options for patients with HMA (hypomethylating agent) failure in myelodysplastic syndrome (MDS). The experts mention ongoing trials with CXCR2 inhibitor and its potential in blast clearance and hematologic improvement. They discuss the possibility of adding Venetoclax as a treatment option at the time of progression for HMA failure patients. Additionally, they highlight the exploration of new targets like IRAK4 inhibition and altered splicing vulnerabilities for progressive MDS. The experts stress the importance of considering transplant as a therapeutic goal and increasing referral rates for MDS patients.
The 64th American Society of Hematology (ASH) Annual Meeting and Exposition took place on December 10-13, 2022, in New Orleans, LA, and saw leading experts from all over the world gather to showcase the latest research in hematological malignancies.
In this podcast, David Sallman, MD, Moffitt Cancer Center, Tampa, FL, and Andrew Brunner, MD, Massachusetts General Hospital, Boston, MA, discuss key updates in myelodysplastic syndromes (MDS) presented at this year’s meeting. Topics covered include the treatment of lower-risk and higher-risk disease, novel classification systems, clinical trial updates, and treatment options after failure to hypomethylating agents (HMAs).