MDS 2023 | Promising doublets under investigation in clinical trials in 1L intermediate- and high-risk MDS

I think this is an important question to address. And the answers would probably be different if you ask the same question maybe a year down the line because I would say we are in a year where we are in a bit of a limbo to answer that question. The reason being, people now are thinking rather than allowing patients to fail on single agent azacitidine in intermediate to in high risk IPSS MDS, would there be strategies to have doublet combinations for example AZA plus venetoclax or AZA plus magrolimab or AZA plus sabatolimab or AZA plus RARA agonist called tamibarotene. But these trials, at least the first three agents in combination with azacitidine has completed enrollment in proper Phase III trials, but I don’t think so the data will be available until probably early to middle of 2024 and that will and hopefully be optimistic in the field of MDS. We’re hopeful that at least one of those combinations, maybe more of those combinations could be useful in the setting of upfront treatment with intermediate to high-risk myelodysplastic syndrome. So, I’m not directly answering your question, but I’m trying to think like maybe in a year’s time if we have better doublet combinations with azacitidine as an upfront treatment, if we have a better chance of response, then there is less chance of failure with those combinations and then need to think of other strategies if doublet combinations fail. But that’s maybe three or four years down the line.