Expert Interview
Discussing Geron’s Imetelstat Treatment in Lower Risk MDS Patients
Ticker(s): GERNInstitution: UCSD Moores Cancer Center
- Associate Professor of Medicine at UCSD and founder of the MDS Center of Excellence at UC San Diego Health.
- Specializes in the care of patients with myelodysplastic syndromes (MDS) and related blood disorders.
- Runs a research laboratory dedicated to the study of MDS with a focus on discovering disease features that can be used to personalize the care of patients with MDS.
- Research led to the development of clinic tests for mutations that help predict prognosis and individualize treatment options for patients; Current research involves investigating how acquired mutations in MDS patients are associated with their response to treatment with drugs like azacitidine and decitabine.
Please describe your practice as a clinician,how many patients with MDS do you see on a yearly basis? What percent are lower risk? Could you walk us through the standard of care, and take us through the most promising upcoming treatments, or interesting clinical trials in this space?
How much of an unmet need is there in Low Risk MDS?
Please discuss the new efficacy data related to the 16% (6/38) of patients in IMerge Phase 2 who were relapsed/refractory to ESAs and had also been treated previously with luspatercept, as follows: 50% (3/6) of these patients achieved ≥8-week TI 67% (2/3) of those ≥8-week TI responders also achieved ≥24-week TI 100% (2/2) of those ≥24-week TI responders also achieved >1 year TI. How satisfactory are the results?
Added By: slingshot_insightsSafety findings included resolution of each of Grade 3/4 thrombocytopenia and neutropenia to Grade 2 or lower within 4 weeks for >97% of patients in the >1 year TI population. What is your impression in that regard?
89% of patients had a reduction in SF3B1 variant allele frequency (VAF) while 56% achieved greater than or equal to 50% VAF reduction. Reduction in VAF correlated with longer TI duration (median, >20 months) and shorter time to onset of TI (median, <10 weeks). How meaningful are those results to you, and do you think it makes a strong case for use of Imetelstat or other telomerase inhibitors in treating MDS?
How much use do you see for Imetelstat in the future? How likely are you to prescribe it to your patients, based on the results to date?
Added By: slingshot_insightsAre the patients without the del 5Q mutation ineligible for ESAs?
If the Commands trial is approved as an alternative to ESAs in the first line setting, do you think luspatercept would take a significant share?
Given the first line data, how do you imagine using Imetelstat in your practice? Would you use it right before a HMA?
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