Mikkael Sekeres, MD
Mikkael Sekeres, MD, Chief of the Division of Hematology at the University of Miami Health System and a hematologist at Sylvester Comprehensive Cancer Center, applauded the IDIOME1 and IDEAL2 investigators for conducting studies. These studies, he noted, were “very difficult because of the rarity of these IDH1/2 mutations.”
“Both studies showed high response rates and good median overall survival in this high-risk population,” he noted. Response rates and median overall survival were 69% and 14 months with ivosidenib, respectively, and 42% and 17 months with enasidenib.
Dr. Sekeres continued: “For higher-risk patients having one of these mutations, I could envision a treatment strategy of reserving the use of ivosidenib or enasidenib following failure of azacitidine. I could also see future studies combining one of these drugs with azacitidine as upfront treatment,” he said.
However, Dr. Sekeres also noted that in the treatment-naive higher-risk cohorts, the response rates and median overall survival did not appear “at face value” to be better than what is achieved with azacitidine monotherapy. When questioned, the investigators indicated they have not yet made those comparisons but predicted that outcomes with the IDH1/2 inhibitors will improve upon current ones.
Should outcomes indeed be improved, Dr. Sekeres said the drugs could represent a step toward more personalized approaches in MDS.
DISCLOSURE: Dr. Sekeres has served on boards of directors or advisory committees for Novartis, Takeda/Millennium, and BMS.
REFERENCES
1. Sebert M, Cluzeau T, Beyne Rauzy O, et al: Ivosidenib monotherapy is effective in patients with IDH1 mutated myelodysplastic syndrome: The IDIOME phase 2 study by the GFM Group. 2021 ASH Annual Meeting & Exposition. Abstract 62. Presented December 11, 2021.
2. Ades L, Dimicoli-Salazar S, Sebert M, et al: Enasidenib is effective in patients with IDH2 mutated myelodysplastic syndrome: The IDEAL phase 2 study by the GFM Group. 2021 ASH Annual Meeting & Exposition. Abstract 63. Presented December 11, 2021.
