Aditi Shastri, MD: Clinicians Need to ‘Come Together’ on TP53-Mutated MDS

In this episode of The HemOnc Pulse, Dr. Shastri a physician-scientist at the Montefiore Einstein Comprehensive Cancer Center in the Bronx, New York, joins host Chadi Nabhan, MD, MBA, FACP, for a deep dive into intriguing abstracts on myelodysplastic syndromes (MDS) presented at the 65th American Society of Hematology (ASH) Annual Meeting & Exposition.

To start off, Drs. Shastri and Nabhan discussed ASH abstract 1002 on the clinical implications of TP53 mutations in MDS.

“I really chose to focus on something that is very much part of our day-to-day clinical discussions and ties into knowledge that we’re gaining in terms of genomic classification of MDS,” Dr. Shastri shared.

Using the VALIDATE database, researchers looked at treatment response to hypomethylating agents (HMAs) and overall survival in patients with TP53-mutated MDS and found that TP53 mutations were associated with worse prognosis.

“I was truly surprised to see that patients in this large dataset—[who] had any variety of TP53 mutations—have a poor impact on survival, but not necessarily response to HMAs,” Dr. Shastri said. “This underscores the fact that we, as a clinical and scientific community, need to come together to try to help our patients with complex karyotype and TP53 mutations, because at this time we don’t have great therapies to offer our patients with this very difficult-to-treat disease.”

Dr. Shastri also discussed the final readout of the COMMANDS trial and its implications on patients with lower-risk MDS.