ASH 2023 | Imetelstat for LR-MDS: insights from the IMerge trial

Valeria Santini, MD, University of Florence, Florence, Italy, comments on the findings of the Phase III IMerge trial (NCT02598661) which compared imetelstat, a first-in-class telomerase inhibitor, to placebo in patients with transfusion-dependent lower-risk myelodysplastic syndromes (LR-MDS) who were relapsed/refractory (R/R) to erythropoiesis-stimulating agents (ESAs). Imetelstat produced encouraging response rates, and 39.8% and 17.8% of patients achieved transfusion independence (TI) at 8 weeks and 1 year, respectively. A decrease in variant allele frequency (VAF) of somatic mutations was observed, suggesting that the drug has disease-modifying activity. Interestingly, TI responses occurred in treated patients regardless of whether they possessed mutations associated with a poor prognosis. The clinical benefit of imetelstat is therefore seen across varying molecular subgroups of the disease. This interview took place at the 65th ASH Annual Meeting and Exposition, held in San Diego, CA.

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