1b) Our content expert for this program is Amer Zeidan MBBS,MHS @Dr_AmerZeidan, Associate Prof, Asst Director CTO, Director #Heme early phase/#Leuksm research, @Yale. @Dr_AmerZeidan is widely published in #MDSsm. pic.twitter.com/rKIiVWNbEI
— @onc_ce (@onc_ce) June 27, 2023
3) This program is supported by an independent educational grant from Bristol Myers Squibb. Statement of accreditation & faculty disclosures at https://t.co/8oShcATovC.
— @onc_ce (@onc_ce) June 27, 2023
5) Let's go back to basics. Per 🔓 https://t.co/DImJ6tEDqc, we have standardized approaches to diagnostic criteria and #DDx for #MDSsm. #Cytopenia definitions include #Hb <13g/dL in ♂️ & <12 in♀️ for anemia and #platelets < 150K for #thrombocytopenia.
— @onc_ce (@onc_ce) June 27, 2023
DDx considerations: pic.twitter.com/J6GIEL7Ahg
6b) Recently, Bernard et al published an enhancement of the IPSS-R, adding somatic gene #mutations, to yield a clinical-molecular prognostic model (IPSS-Molecular [#IPSS_M]), improving #MDSsm #riskstrat.
— @onc_ce (@onc_ce) June 27, 2023
🔓https://t.co/1TmhdWnIHg
6d) …that is, a hypothetical pt with mean values for all variables), whereas values of −1, 1, or 2 corresponded to half, double, or fourfold risk compared with the average patient, respectively. pic.twitter.com/rHkk7hEqOe
— @onc_ce (@onc_ce) June 27, 2023
7) #Anemia is the predominant cytopenia seen in pts with #MDS; many pts require regular #RBC transfusions. #ESAs have been #SoC in anemic pts with lower-risk MDS (#LR_MDSsm). However, many pts did not respond, and the ones who did respond typically stopped responding within 2 y.
— @onc_ce (@onc_ce) June 27, 2023
8b) This was a comparison of #luspatercept vs #EPO as upfront management of RBC transfusion-dependent anemic #LR_MDSsm pts. The study has now been published in @TheLancet: https://t.co/6LvvhCuwmC
— @onc_ce (@onc_ce) June 27, 2023
8d) #Luspatercept is already approved by @US_FDA as a second line agent for ring #sideroblast #RS-positive pts based on the #Medalist trialhttps://t.co/Rfj6kXeLo1
— @onc_ce (@onc_ce) June 27, 2023
10) Enrolled in this open-label randomized study were anemic patients w/ IPSS-R defined LR-#MDS, #ESA naive, requiring regular RBC #transfusions (avg transfusion req of 2-6 RBC u/8wk for ≥ 8 weeks immediately prior to randomization).
— @onc_ce (@onc_ce) June 27, 2023
12a) Looking deeper, #transfusion independence #TI was also improved with #luspatercept compared to #EPO, across all subgroups except for RS -ve patients where the response appeared similar (though response favored luspatercept in pts with #SF3B1 mutations).
— @onc_ce (@onc_ce) June 27, 2023
13) Importantly, safety of luspatercept was confirmed with no new safety concerns when using #luspatercept compared to #EPO in patients enrolled in #COMMANDS: pic.twitter.com/7XCxjHmb82
— @onc_ce (@onc_ce) June 27, 2023
14b) cont
— @onc_ce (@onc_ce) June 27, 2023
🔑 #luspatercept benefit consistent across subgroups except RS -ve patients but including SF3B1-mutated pts
🔑luspatercept has solid safety profile, consistent with Ph 2 experience, with q3w administration
15) What about #LR_MDS that is relapsed or refractory to erythropoiesis stimulating agents (ESAs)—so beyond 1L options? There’s breaking news there too, also from #ASCO23, courtesy of @Dr_AmerZeidan of @Yale and the Ph 3 #IMerge study of #imetelstat.
— @onc_ce (@onc_ce) June 27, 2023
🔓 https://t.co/iGn3ULJ169 pic.twitter.com/CIefe8tMSO
17b) Here is the design of this Ph 3 placebo-controlled trial: pic.twitter.com/oN2pJqo4qt
— @onc_ce (@onc_ce) June 27, 2023
17d) Benefit was seen both in patients with and without ring sideroblasts #RS. Important to note that reduced variant allele frequency was observed in the most commonly mutated myeloid genes . . .
— @onc_ce (@onc_ce) June 27, 2023
18a) So, what have you learned?
— @onc_ce (@onc_ce) June 27, 2023
The first and only therapy shown to be superior to #ESAs in the first-line management of anemic pts with RBC transfusion-dependent #LR_MDSsm is:
18c) The correct answer, as per the #IMerge trial data, is d, #imetelstat. Great job! pic.twitter.com/fdSZhD0WwX
— @onc_ce (@onc_ce) June 27, 2023
19) So . . . heady days in management of #LR_MDSsm, w/potential new 1L & 2L therapies! And you just earned 0.5hr 🆓 CE/#CME! Claim your certificate at https://t.co/sccaaRNklJ, and FOLLOW US for more #MedEd #FOAMed #onctwitter #MDSsm@Dr_AmerZeidan & @onc_ce thank you for joining!
— @onc_ce (@onc_ce) June 27, 2023