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SOHO 2026 | Updated OS and long-term data from the COMMANDS trial: luspatercept versus ESAs in LR-MDS
Valeria Santini, MD, University of Florence, Florence, Italy, comments on updated results from the COMMANDS trial (NCT03682536), highlighting significant improvements in hemoglobin levels and transfusion independence, as well as prolonged overall survival with luspatercept compared to erythropoiesis-stimulating agents (ESAs) in patients with low-risk myelodysplastic syndromes (LR-MDS). She also notes that patients who received luspatercept earlier in their disease course responded more quickly and maintained a longer duration of response. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
So we obtained a very good response in terms of transfusion independence and a significant increase in hemoglobin in the COMMANDS trial comparing luspatercept to ESA. What we observed in the long follow-up, more than three years, in terms of overall survival, is the fact that patients indeed had a very prolonged overall survival, and the patients who were treated with luspatercept had really an advantage in survival over the ones treated with ESA...
So we obtained a very good response in terms of transfusion independence and a significant increase in hemoglobin in the COMMANDS trial comparing luspatercept to ESA. What we observed in the long follow-up, more than three years, in terms of overall survival, is the fact that patients indeed had a very prolonged overall survival, and the patients who were treated with luspatercept had really an advantage in survival over the ones treated with ESA. But not only that. So there was a 22% decrease in risk of death in the patients treated with luspatercept. And what was clear was that if you treat patients at the beginning of their disease, so when their serum EPO level is below 200, when the transfusion burden is below four units in the eight weeks, and when the hemoglobin levels are not so incredibly low, these patients will respond sooner and maintain response for a longer period, more than 180 weeks. So it’s quite a long time. So I think we really obtained something substantial for these patients.
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