Where are we exactly with respect to personalised treatment for MDS patients?

Sophie Wintrich, Chief Executive of MDS Patients Support Group interviewed Dr Catherine Cargo – Consultant Haematologist at St James University Hospital – Leeds. Watch the video and read the transcript below.

MDS: A disease where everybody is different

When we think about personalised treatment we think about a disease where everybody is different. We group all these patients together, but everybody’s disease has slightly different changes in the genetic make-up of the disease and also how they progress or how they do in the duration of their disease.

The really interesting thing about where we are with MDS now is that we will hopefully be able to personalise treatment for the patient so we can look at the patient - look at their individual disease and what abnormalities they have - and then potentially target those abnormalities with specific drugs.

"We are starting to see particular drugs which target specific abnormalities"

I think that it is an exciting time, because we are now starting to see particular drugs which target abnormalities or genetic mutations which are found in MDS and certain patients will respond very well to those.

Another interesting thing is that we can use technologies to identify patients who will respond to more generic drugs - drugs that we at the minute give to everybody. There will be certain patients who will respond very well to those and we should be able to use a lot of these new technologies to identify patients who will respond better, and give patients an idea of how they are going to do on treatment and what their future holds.

Does it mean that all patients must have genetic mutation test?

Q: Does that mean we should start to insist that all patients must have genetic mutation tests to establish which treatments may work out best for them?

I think we are getting to the point where this information is going to be useful in the clinic. We are still gathering information and the tests that we use are still quite difficult and quite complicated for a lot of different labs. And at the minute we don’t have a very standardized way of doing this, so there is quite a lot of work that needs to be done before we get to the point where we can offer this as a blanket test for everybody. I think we will get there and it is something that we will do in the future. It is an option, we can do it in the UK. It’s exciting and I think it will be offered in future, but we shouldn't necessarily be insisting on it now. There are certain cases where it will be particularly helpful and it’s definitely being applied in the clinical trial setting. It will be very interesting gathering that information. At some point in the future we will be able to insist that patients do get this testing done.

Q: How far off is this future?
I don’t think that it is that far off. This is something that we are going to be doing quite soon. The technology is there. It’s becoming cheaper and cheaper to do, and it’s becoming easier to do, even within the NHS. So I think within the next couple of years we will be seeing this as a routine test for MDS patients.

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