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SOHO 2026 | Addressing the biggest challenges in the treatment of MDS
Valeria Santini, MD, University of Florence, Florence, Italy, discusses current challenges in treating myelodysplastic syndromes (MDS), highlighting the need to improve outcomes in higher-risk MDS, where results have stagnated for nearly 20 years. Prof. Santini also emphasizes the need to determine the best course of action for patients who initially respond to treatment but then lose response, particularly those dependent on transfusions. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
There are several open questions still, although we had progress. So the first open question is how to improve the results of treatments in higher risk MDS. We are stuck with the results of a study in a single drug that we studied that was already, I think, almost 20 years ago. So it’s an old study, but it was not possible until now to couple azacitidine with other drugs that are increasing not only the response, but also the overall survival of treated patients...
There are several open questions still, although we had progress. So the first open question is how to improve the results of treatments in higher risk MDS. We are stuck with the results of a study in a single drug that we studied that was already, I think, almost 20 years ago. So it’s an old study, but it was not possible until now to couple azacitidine with other drugs that are increasing not only the response, but also the overall survival of treated patients. So we are facing this big problem. It’s an obstacle. We are stuck with the results of 20 years ago. And although several clinical trials have been performed, none of them was successful in meeting the endpoints. So this is a very open question. The other increasingly important question is what to do with patients who do respond and then lose response to the first treatment line. So hypomethylating agents for high-risk MDS and for lower-risk MDS, the treatment with ESA’s and luspatercept and imetelstat and then lose response but still facing survival. So depending for some years on transfusions.
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