IBC 2025 | Why we should treat precursor conditions including CHIP and CCUS to prevent progression

It’s a very legitimate question. Individuals with CHIP or CCUS are generally well. They don’t have any symptoms and many of them will remain asymptomatic for the rest of their life. So it’s a legitimate question as to why are we treating these individuals? Why do we want to interfere? Another reason that I believe we should be interfering, we should be working to prevent progression of these individuals is because the conditions they progress to are nasty conditions and many individuals will not survive those conditions. So there is a proverb that says prevention is better than cure but in this case we don’t necessarily even have the cure, so certainly prevention is much better than no cure. Now why are people a little bit hesitant is because of the concept of giving treatments to individuals that are well. You know I can perfectly understand that. But of course we’ve learned a lot over the last few years about the behavior of the precursor conditions, clonal hematopoiesis or CHIP and CCUS. We know that there are slow developing conditions, they may take years to progress, and we are not thinking in terms of aggressive treatments that will be given to healthy individuals, we’re thinking of subtler treatments that will stop the progression that is, as I said, a very lengthy process. So overall, I think we have enough to consider treatment. We, of course, have to adjust them to ensure that they’re largely side effect free, they can be tolerable, and people can take them for longish periods without many problems. So I feel strongly that recent advances have also identified such treatments that can be given without major toxicities. So I think we have reached the point where we should be doing clinical studies, because we’ve never done clinical studies or trials in this context.

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