Recent Updates in Risk Stratification and Treatment Methods for Patients With MDS

At the 2024 Great Debates and Updates (GDU) in Hematological Malignancies in New York, New York, Aditi Shastri, MD, Montefiore Medical Center, New York, New York, shares expert insight on recent updates in risk stratification and treatment regimens for patients with low- to intermediate-risk myelodysplastic syndromes (MDS).

Transcript:

Hi, I'm Aditi Shastri. I'm an attending physician and associate professor at the Montefiore Einstein Comprehensive Cancer Center in Bronx, New York. I'm excited to be here at [the Great Debates & Updates] (GDU) [in] Hematolog[ical] [Malignancies] [meeting]. My talk today focuses on recent updates in risk stratification and treatment for patients with low- to intermediate-risk myelodysplastic syndromes. [The years] 2023 and 2022 [were] exciting year[s] for myelodysplastic syndromes.

We have updated risk stratification systems and prognostic systems like the [Molecular International Prognostic Scoring System] (IPSSM) that we are incorporating more into planning the treatment paradigm for our patients. We also have now newer therapies to offer. We have luspatercept, which was available in the second line after erythropoietin and is an activin receptor-ligand trap and now is the frontline option. This is something that I discussed as well during my talk as to how I'm offering patients erythropoietin versus luspatercept, [and] now that it's moved into the first line, we're using it more as a frontline option.

There is exciting data that just came out from a recent phase 3 study of a telomerase enzyme inhibitor, a drug called imetelstat, where the activity also looks very favorable after the failure of erythropoietin or for patients that were not candidates for erythropoietin.

These were some of the updates for myelodysplastic syndromes, which hopefully translates into better patient care. There are still some challenges that we deal with in the clinic, and one of them is transfusion burden and [the] iron overload that we see [because of] it. We also still have this problem of thrombocytopenia and need better options for [that]. We may have some updates next year at GDU Hematology to address those.

Source:

Shastri A. Transplant Considerations for MDS Patients Undergoing AlloHSCT. Presented at the 2024 Great Debates & Updates in Hematological Malignancies: April 5-6, 2024. New York City, NY.