Multinational phase 3 trial of luspatercept versus epoetin alfa for ESA-naïve, transfusion-dependent, lower-risk myelodysplastic syndromes

Erythropoiesis-stimulating agents (ESAs) are standard-of-care for anemia in most patients with lower-risk myelodysplastic syndromes (MDS) but responses are limited and transient. The multinational phase 3 COMMANDS trial compares luspatercept versus epoetin alfa for anemia in ESA-naïve, transfusion-dependent, lower-risk MDS. Prespecified interim analysis of the trial found that luspatercept compared with epoetin alfa improved the rate at which red blood cell transfusion independence and increased hemoglobin were achieved. Longer follow-up will be needed to confirm these findings.