Evolving Practices for Myelodysplastic Syndromes (MDS): Highlights from ASH 2024 and Beyond

The panelists discuss the newest risk stratification tool, IPSS-M.

Panelists discuss how the primary therapeutic goals for patients with intermediate- to high-risk myelodysplastic syndromes (MDS) focus on extending survival and modifying disease course through intensive treatments like hypomethylating agents or stem cell transplantation while addressing unique challenges such as treatment resistance, poor response durability, and limited options after hypomethylating agents failure.

Panelists discuss how hypomethylating agents remain the cornerstone of therapy for intermediate to high-risk patients with myelodysplastic syndromes (MDS).

Panelists discuss how the ASCERTAIN trial demonstrated that oral decitabine plus cedazuridine provided comparable efficacy to injectable decitabine.

Panelists discuss how oral decitabine/cedazuridine showed encouraging efficacy in patients with myelodysplastic syndromes (MDS) with TP53 mutations, suggesting this oral formulation could be particularly beneficial for this historically difficult-to-treat molecular subgroup.

Panelists discuss how oral decitabine/cedazuridine demonstrated meaningful clinical activity in patients with TP53-mutated myelodysplastic syndromes (MDS), with a 31% complete response rate and 16.1-month median overall survival, representing an important treatment advance for this traditionally poor-prognosis molecular subgroup.

Panelists discuss how treatment strategies for myelodysplastic syndromes (MDS) are fundamentally guided by risk stratification, with lower-risk patients typically receiving supportive care and less intensive treatments focused on quality of life and symptom management while intermediate- to high-risk patients require more aggressive approaches, including hypomethylating agents and consideration for stem cell transplantation, with emerging data supporting novel combinations and targeted therapies across the risk spectrum.

Panelists discuss how the future treatment landscape for myelodysplastic syndromes (MDS) appears promising with several ongoing clinical trials exploring novel combinations and targeted therapies, including investigations of venetoclax combinations, magrolimab, sabatolimab, and other immune-based approaches that could potentially improve outcomes across different risk groups and molecular subtypes.