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Rafael Bejar, MD, PhD, head of the MDS Center of Excellence at the University of California, San Diego, explains how the small number of mutationdriven MDS treatments remains a challenge. These treatments include targeted therapy for mutations in the genes IDH1 and IDH2, as well as luspatercept for people with a mutation in SF3B1. Learning about resistance mutations is also important for improving treatment response and developing additional mutationdriven MDS therapies.