Guillermo Garcia-Manero, MD, Discusses the Final Data From COMMANDS

By Guillermo Garcia-Manero, MD - Last Updated: February 21, 2024

Blood Cancers Today spoke with Guillermo Garcia-Manero, MD, of the University of Texas MD Anderson Cancer Center, ahead of his presentation at the 65th American Society of Hematology Annual Meeting & Exposition in San Diego, California, detailing the final data update from the COMMANDS trial.

Advertisement

The phase III COMMANDS trial compared luspatercept with epoetin alfa, an erythropoiesis-stimulating agent (ESA), in patients with low-risk myelodysplastic syndromes (MDS) dependent on transfusions. Dr. Garcia-Manero noted that initial analyses from the trial had been presented at previous meetings before discussing the results of the final analysis.

“The data that I will be presenting shows that, in general, luspatercept is superior to an ESA as a front-line drug for patients with low-risk myelodysplastic syndromes, so that did not change. The other important issue from the COMMANDS trial was the duration of response, what I refer to as ‘quality of response,’ was also in favor of luspatercept versus the control arm, the ESA, so that did not change.”

Dr. Garcia-Manero did point out some findings in the final update that differed from earlier analysis. “There were a couple of interesting features from this late analysis that I think are worth mentioning. The first one comes to this issue of the response rate with luspatercept in [ring sideroblastic (RS)]-negative versus RS-positive patients.”

The authors’ original analyses showed a slight difference in response favoring the ESA when compared with luspatercept. However, “what is interesting with the updated analysis is this has now neutralized, so the response rate is virtually identical…in the context of RS-negative patients,” according to Dr. Garcia-Manero.

The late analysis did also identify a surprising outcome that was missed in earlier analysis, Dr. Garcia-Manero said. “It appears that the duration of response in the subset of patients with RS-negative disease is actually longer than we expected, and actually potentially even longer than what we see in patients with RS-positive disease. So this is interesting, right, because the response rate doesn’t seem to be much higher compared to standard-of-care, but the duration of the response seems to be longer.”

Dr. Garcia-Manero acknowledged that more data on luspatercept is needed, but suggested that, “overall, what we learned from this updated data at ASH is that the response rate, the duration of response, and finally the toxicity profile of this compound are basically along the lines of what we presented at the original meetings, and this is now becoming, in my opinion, a really wonderful agent that we have for anemic patients with lower-risk myelodysplastic syndrome.”

Post Tags:ASHMDS23
Advertisement
Advertisement
Advertisement
Editorial Board