At the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas, Blood Cancers Today asked Solly Chedid, MD, of Singing River Cancer Center in Gulfport, Mississippi, about the meaning of the phase III COMMANDS trial results for myelodysplastic syndrome (MDS) care.
Dr. Chedid said that COMMANDS was the first ever head-to-head trial to compare luspatercept against an erythropoiesis-stimulating agent, specifically epoetin alfa, in the management of anemia in transfusion-dependent MDS. He said that luspatercept demonstrated superior efficacy to epoetin alfa in the number of patients who responded to treatment, duration of effect, and degree of increase in hemoglobin.
“When your hemoglobin stays higher for a longer period of time, potentially, those patients are not going to fail therapy and aren’t going to need hypomethylating agents for a much longer period of time,” Dr. Chedid added.
In Dr. Chedid’s view, the only advantage of epoetin alfa over luspatercept in MDS care is that it is somewhat less expensive. He said that in the ring sideroblast negative portion of COMMANDS, in which luspatercept and epoetin alfa appeared to produce similar efficacy, the two patient populations may not necessarily have been comparable.