ISAL 2023 | The impact of IDH mutations in MDS & evaluating the role of IDH inhibitors
David Sallman, MD, Moffitt Cancer Center, Tampa, FL, discusses the impact of IDH mutations in patients with myelodysplastic syndromes (MDS), and further highlights trials evaluating various IDH inhibitors, including ivosidenib, enasidenib and olutasidenib. This interview took place at the 18th International Symposium on Acute Leukemias (ISAL XVIII), held in Munich, Germany.
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Transcript (edited for clarity)
IDH mutations in MDs are quite rare. So, if you take IDH1, that percentage is about 2 to 3%. You know this is versus maybe 8 or 8 to 10% in AML. Similarly, much more rare with IDH2. There’s now been several trials both with ivosidenib, enasidenib, actually some with olutasidenib you know as well, including some randomized trials that are ongoing in Europe. Actually, if you look in the MDS patient population, the responses are at least as good if not better...
IDH mutations in MDs are quite rare. So, if you take IDH1, that percentage is about 2 to 3%. You know this is versus maybe 8 or 8 to 10% in AML. Similarly, much more rare with IDH2. There’s now been several trials both with ivosidenib, enasidenib, actually some with olutasidenib you know as well, including some randomized trials that are ongoing in Europe. Actually, if you look in the MDS patient population, the responses are at least as good if not better. Actually we have published a recent paper where we had some severe neutropenia lower-risk patients with IDH1 mutation and actually both of those patients achieved a sort of complete hematologic response immediately and have been on therapy for years, and potentially utilizing it earlier before they even become AML actually may lead to longer durations of responses. I think these patients are very rare. If you look at the time for the ivosidenib trial to enroll, it’s been taking years. Hopefully we’ll get more definitive data out in the near future and we actually hope that we can get a label approval for IDH inhibitors with MDS patients. But I think even off-label these drugs are quite effective in the MDS patient population.
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