Can we do better than HMA in HR-MDS?

Guillermo Garcia-Manero, MD, McCredie Professor of Medicine, Vice Chair, Department of Leukemia, Chief, Section of MDS, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Treatment options for patients with higher-risk MDS (HR-MDS) include hypomethylating agents, AML-like therapy and stem cell transplantation (SCT). At the time of writing this abstract, no therapy has been shown to be superior to single agent azacitidine in a randomized clinical trial and SCT is still restricted to fit patients with a suitable donor. In this presentation, I will: discuss what constitutes HR-MDS in 2023; update on the development of oral hypomethylating agents; data of combinations with hypomethylating agents; a role for targeted interventions against IDH1, IDH2 and Flt-3 and a model for incorporation of SCT. Finally, I will also discuss re-emerging data with AML-like therapy and the limited options for HMA-failure MDS. In 2024, we expect the results of the Verona trial that could change our approach to the treatment of this group of patients. At the conclusion of this presentation hopefully I would have share our a modern treatment approach to HR-MDS