Mikkael A. Sekeres, MD

Mikkael A. Sekeres, MD, Professor of Medicine and Chief of the Division of Hematology, Sylvester Cancer Center, University of Miami, said the COMMANDS trial delivered promising results for the treatment of lower-risk myelodysplastic syndrome (MDS).

“Without question, the COMMANDS study met its primary endpoint, showing that patients with lower-risk MDS who were dependent on red blood cell transfusions were significantly more likely to achieve transfusion independence lasting 12 or more weeks when treated with luspatercept compared with erythropoiesis-stimulating agents [ESAs]. The difference in the rates of transfusion independence were maintained when measured for a 24-week period, too, which is more clinically meaningful to patients,” he told The ASCO Post.

Dr. Sekeres noted that much of the difference in transfusion independence rates was driven by patients with ring sideroblasts—which is the current indication for on-label, post-ESA treatment. However, the duration of response was prolonged for both ring sideroblast–positive and –negative subsets, a median of more than 2 years, he observed.

“It remains to be seen whether ESA dosing and treatment duration were adequate in this unblinded study, whether the drug label will be expanded to upfront therapy, and, if so, whether it will be for patients without as well as with ring sideroblasts,” commented Dr. Sekeres. 

DISCLOSURE: Dr. Sekeres has served on the advisory board of Bristol Myers Squibb.