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Opinion|Videos|October 15, 2024

First-Line Luspatercept in LR-MDS: A Deep Dive Into the COMMANDS Trial and Clinical Implications in the Real-Life Practice Setting

Author(s)James K. McCloskey, MD, John Theurer Cancer Center, Thomas W. LeBlanc, MD, MA

Panelists discuss how luspatercept’s mechanism of action, its first-line indication for patients with lower-risk MDS with ring sideroblasts, and the results of the COMMANDS trial support its use as an effective alternative to traditional erythropoiesis-stimulating agents, potentially changing the treatment landscape for transfusion-dependent patients with MDS.

Episodes in this series

2 KOLs are featured in this series.

EP. 1 Understanding Myelodysplastic Syndromes (MDS): Diagnosis, Classification, and Risk Assessment

2 KOLs are featured in this series.

EP. 2 Navigating the Heterogeneity of LR-MDS: Importance of Molecular Testing & Risk Stratifying

2 KOLs are featured in this series.

EP. 3 Clinical Scenario 1: 76-Year-Old Man With Newly Diagnosed MDS With Symptomatic Anemia, RS Positive

2 KOLs are featured in this series.

EP. 4 Tailoring Treatment for LR-MDS: Patient Factors, Treatment Goals, and Patient Outcomes

2 KOLs are featured in this series.

EP. 5 First-Line Luspatercept in LR-MDS: A Deep Dive Into the COMMANDS Trial and Clinical Implications in the Real-Life Practice Setting

2 KOLs are featured in this series.

EP. 6 Managing Luspatercept Therapy: Dosing, Adverse Effects, and Monitoring

2 KOLs are featured in this series.

EP. 7 Second-Line LR- MDS Setting: Treatment Options and Considerations

2 KOLs are featured in this series.

EP. 8 Patient Profile: 66-Year-Old Woman with Newly Diagnosed LR-MDS, RS Negative

2 KOLs are featured in this series.

EP. 9 Luspatercept Role in the RS-Negative Population and Expert Perspectives on the Role of EPO Levels

2 KOLs are featured in this series.

EP. 10 First-Line ESA vs Luspatercept in LR-MDS: Choosing the Most Appropriate Treatment Option for Each Individual Patient

2 KOLs are featured in this series.

EP. 11 Imetelstat and IMerge Trial Review

2 KOLs are featured in this series.

EP. 12 Looking Ahead in LR-MDS: Future Agents and/or Combination Strategies

2 KOLs are featured in this series.

EP. 13 The Future of Lower-Risk MDS: Closing Thoughts and Unmet Needs

Video content above is prompted by the following:

Please describe the mechanism of luspatercept and luspatercept’s indication in the first-line setting
Please summarize the COMMANDS trial (Della Porta MG, et al. Lancet Haematol, 2024).
Please comment on the study design, pertinent patient characteristics, and primary/secondary end points.
What are your impressions of the recently published full analysis of the COMMANDS trial?
What are the clinical implications of this study?
What are your impressions and interpretation of luspatercept’s impact on the various hematopoietic stem cell lineages (erythroid, neutrophil, platelet)? How do these data impact your day-to-day practice?
Resource links: Luspatercept’s impact on erythroid, neutrophil, and platelet lineages. Garcia-Manero G, et al. EHA 2024. Abstract P780 & COMMANDS trial (Della Porta MG, et al. Lancet Haematol, 2024)

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