Dr Jain on Unmet Needs in the Treatment of Low- and High-Risk MDS

Akriti Jain, MD, Department of Hematology and Medical Oncology, Cleveland Clinic, discusses unmet needs in patients with low- and high-risk myelodysplastic syndromes (MDS).

When addressing unmet needs in patients with MDS, it's essential to differentiate between patients classified as having low-risk and high-risk disease, Jain begins. In the realm of low-risk MDS, several drugs are currently available or in development that hold promise for improving patient outcomes, Jain says. Among these, erythropoiesis-stimulating agents, luspatercept-aamt (Reblozyl), and azacitidine (Vidaza) stand out as notable options, she reports. Additionally, the emergence of innovative drugs, such as imetelstat, that are pending regulatory approval in this therapeutic setting presents exciting prospects, Jain emphasizes. Further exploration into promising therapeutic candidates, such as KER-050, which was highlighted at the 2023 ASH Annual Meeting, and monoclonal antibodies, offers potential avenues for enhancing treatment efficacy and quality of life (QOL) for low-risk patients, Jain explains. These treatment opportunities underscore the ongoing efforts to address cytopenias and overall patient well-being in this subgroup, she adds.

Conversely, for patients classified as having high-risk MDS who are deemed transplant candidates, the primary objective is to facilitate their transition to transplantation and strive for optimal responses in the frontline setting, Jain continues. Here, the combination of azacitidine and venetoclax (Venclexta) emerges as a pivotal therapeutic approach, representing a significant area of clinical innovation and investigation, according to Jain. However, for patients who are not deemed suitable candidates for transplantation, the focus shifts toward mitigating cytopenias and improving overall response rates, she elucidates. Novel combination therapies offer a compelling avenue for augmenting treatment efficacy in this patient cohort, Jain says. By exploring innovative therapeutic approaches, oncologists aim to treat patients’ existing cytopenias and enhance patient outcomes by minimizing treatment-related complications and maximizing therapeutic benefits, Jain expands.

In essence, the pursuit of improved treatment strategies for patients with MDS encompasses a multifaceted approach tailored to the distinct needs of both low-risk and high-risk subgroups, she says. By leveraging a diverse array of therapeutic agents and novel combinations, oncologists endeavor to optimize treatment outcomes, alleviate cytopenias, and enhance overall QOL for patients with this complex hematological disorder, Jain concludes.