Optimizing Care for Lower-Risk Myelodysplastic Syndromes: Translating Evidence to Clinical Practice - Episode 5

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

October 15, 2024

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.

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

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

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

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

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

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

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

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

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

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

EP. 11: Imetelstat and IMerge Trial Review

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

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)