EHA 2023 | The COMMANDS study: luspatercept versus epoetin alfa for ESA-naïve lower-risk MDS-associated anemia
Matteo Della Porta, MD, Humanitas University and Research Hospital, Milan, Italy, discusses the Phase III COMMANDS study (NCT03682536) investigating the efficacy and safety of luspatercept versus epoetin alfa for the treatment of ESA-naïve low-risk myelodysplastic syndromes (MDS)-associated transfusion-dependent anemia. Prof. Della Porta shares, alongside other key results, that more patients taking luspatercept achieved the primary endpoint of a mean hemoglobin increase ≥1.5 g/dL. This interview took place at the 28th Congress of the European Hematology Association (EHA) 2023 in Frankfurt, Germany.
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Transcript (edited for clarity)
The COMMANDS trial is a Phase III randomized study that compared the efficacy and safety of luspatercept versus epoetin alpha in the treatment of transfusion-dependent, ESA-naïve, low risk MDS. The primary endpoint of the study was defined as the achievement of transfusion independence for at least 12 weeks, combined with a mean increase in hemoglobin level of at least 1.5g/dL. The primary endpoint was achieved in 59% of patients treated with luspatercept versus 31% of patients receiving epo...
The COMMANDS trial is a Phase III randomized study that compared the efficacy and safety of luspatercept versus epoetin alpha in the treatment of transfusion-dependent, ESA-naïve, low risk MDS. The primary endpoint of the study was defined as the achievement of transfusion independence for at least 12 weeks, combined with a mean increase in hemoglobin level of at least 1.5g/dL. The primary endpoint was achieved in 59% of patients treated with luspatercept versus 31% of patients receiving epo. And importantly, the clinical benefit of luspatercept was observed in all patient subgroups stratified by endogenous EPO level, the severity of transfusion dependence, the mutational status of SF3B1 gene and the presence of ring sideroblasts.
The other key result from this study was that luspatercept provided longer duration of transfusion independence with respect to epoetin alpha. Overall, the treatment was associated with a good safety profile that was consistent with previous clinical experience. And overall, these results may suggest a paradigm shift for the treatment of low risk MDS-associated severe anemia.
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