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IBC 2025 | Challenges and opportunities in early interventional trials for clonal hematopoiesis
Mrinal Patnaik, MBBS, Mayo Clinic, Rochester, MN, highlights the challenges and opportunities regarding early interventional trials in clonal hematopoiesis (CH). He notes the lack of a universal screening algorithm and the need for more accurate risk prediction models. Dr Patnaik emphasizes the importance of developing surrogate endpoints and effective treatments to intervene with CH. This interview took place at the 3rd Intercepting Blood Cancers (IBC) Workshop held in Nice, France.
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Transcript
I think there are a lot of challenges. Number one, we still don’t know how to screen for who we want to treat. There is no universal screening algorithm. The testing that is used to detect CH is very heterogeneous. Every institution has their own panels, their own depths of sequencing. Once we detect CH, we do have a few risk prediction models, but they’re not perfect...
I think there are a lot of challenges. Number one, we still don’t know how to screen for who we want to treat. There is no universal screening algorithm. The testing that is used to detect CH is very heterogeneous. Every institution has their own panels, their own depths of sequencing. Once we detect CH, we do have a few risk prediction models, but they’re not perfect. And there’s still a lot of work needed to truly identify those patients who are going to benefit from intervention. And while there are a few clinical trials that have been performed, what we’re really missing is regulatory endpoints. So, you know, when you target a particular clone, because these are precursor states, following them for overall survival could take years, may not be financially feasible to do the study. So we need to find surrogate endpoints that can convince us that this is truly benefiting the patient. And then, of course, finding the right drugs or combination of drugs, whether, as I said, they’re vaccines or they’re immunotherapy. I think that combination is where we need to spend time so that we can come up with useful modalities to intervene with.
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