Imetelstat and Canakinumab in Lower-Risk MDS
Drs Safah and Koprivinikar discuss emerging therapies, such as imetelstat and canakinumab, and where they might fit in the treatment paradigm for lower-risk MDS.
This is a video synopsis/summary of a Precision Medicine series featuring Hana Safah, MD, and Jamie Koprivnikar, MD.
Drs Safah and Koprivnikar emphasize that managing lower-risk myelodysplastic syndromes (MDS) requires focusing on patient symptoms and quality of life rather than just laboratory values. Emerging data suggest new therapies like luspatercept, imetelstat, and canakinumab may provide further benefits beyond addressing anemia by reducing inflammatory signals implicated in MDS pathogenesis.
Imetelstat induced durable transfusion independence in heavily pretreated patients and decreased allele burden of MDS-related mutations over time, indicating disease modification. Though early phase, canakinumab also improved anemia while impacting inflammatory markers.
Such insights call into question the paradigm of purely symptomatic treatment and support intervening earlier in disease processes or clonal states preceding MDS. As cardiovascular risks are also mediated by inflammation, mitigating these pathways could improve overall outcomes.
Ongoing trials in patients with clonal cytopenias of undetermined significance and lower-risk MDS will uncover optimal sequencing and combination strategies maximizing responses. However, currently available therapies are already expanding management options for this predominantly elderly population.
Video synopsis is AI-generated and reviewed by Targeted Oncology® editorial staff.
