Rami Komrokji, MD, on What's Next for Luspatercept in MDS

Dr. Komrokji of the Moffitt Cancer Center discusses what he sees on the horizon following the recent US Food and Drug Administration (FDA) approval of luspatercept for certain patients with myelodysplastic syndromes (MDS).

“Our next step is … to try to move the treatment in patients that are not transfusion-dependent because, in practice, most of the time we start patients with therapy once they are anemic and not wait for transfusion dependency,” he said.

The FDA recently approved luspatercept for the frontline treatment of anemia without previous erythropoiesis-stimulating agent use in adults with very low- to intermediate-risk MDS who may require regular red blood cell transfusions.

The approval was based on interim results from the pivotal phase III COMMANDS trial.

“It’s exciting because in reality, erythroid-stimulating agents have been used for decades for MDS, but there has never been an FDA approval,” Dr. Komrokji said. “This is the first upfront or first-line therapy to be approved in MDS, and hopefully we keep working on this to make those options better for our patients.”

The trial, which evaluated luspatercept versus epoetin alfa for treatment of anemia in patients with lower-risk MDS who were naive to erythropoiesis-stimulating agents and required red blood cell transfusions, showed that nearly twice as many patients achieved transfusion independence and hemoglobin increase with luspatercept.