How Have the COMMANDS Trial Data Changed Lower-Risk MDS Care?

A roundtable discussion, moderated by Amer Zeidan, MBBS, MHS, of Yale University, focused on the latest updates in the care of myelodysplastic syndromes (MDS). The panel included David Swoboda, MD, of Tampa General Hospital; Jamie Koprivnikar, MD, of Hackensack University Medical Center; and Sangeetha Venugopal, MD, MS, of the Sylvester Comprehensive Cancer Center in Miami.

In this segment of the discussion, Dr. Zeidan described how erythropoiesis-stimulating agents (ESAs) had long been the only available treatment for anemia caused by MDS. He asked Dr. Swoboda about the impact of findings from the COMMANDS trial—which compared luspatercept against ESAs in ESA-naïve, transfusion-dependent patients—on frontline management of lower-risk MDS.

A major result was that luspatercept produced nearly twice as much transfusion independence in patients as ESAs did, Dr. Swoboda responded. Moreover, luspatercept brought transfusion independence that lasted approximately one year longer than that from ESAs, and such an impressive duration was seen even in the higher-risk molecular subsets of disease.

“Overall, it was a huge practice changer for the entire MDS community. In the majority of patients we now use luspatercept in the front line,” Dr. Swoboda said.