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Conference/Presentation Title: | MDS-166 clinical benefit of luspatercept treatment in transfusion-dependent (TD), erythropoiesis-stimulating agent (ESA)-naive patients with very low-, low-, or intermediate-risk myelodysplastic syndromes (MDS) in the COMMANDS trial. | Authors: | Zeidan A.M.;Platzbecker U.;Giovanni Della Porta M.;Santini V.;Garcia-Manero G.;Li J.;Kreitz S.;Pozharskaya V.;Rose S.;Lai Y.;Davidarcel D.;Fenaux P.;Shortt J. ;Komrokji R.S. | Monash Health Department(s): | Haematology | Institution: | (Zeidan) Department of Internal Medicine, Yale School of Medicine and Yale Cancer Center, Yale University, New Haven, CT, United States (Platzbecker) Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany (Giovanni Della Porta) Cancer Center IRCCS Humanitas Research Hospital, Milan, Italy (Giovanni Della Porta) Department of Biomedical Sciences, Humanitas University, Milan, Italy (Santini) MDS Unit, DMSC, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy (Garcia-Manero) Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States (Li, Pozharskaya, Rose, Lai) Bristol Myers Squibb, Princeton, NJ, United States (Kreitz) Celgene International Sarl, a Bristol-Myers Squibb Company, Boudry, Switzerland (Davidarcel) Vall Hebron Institute of Oncology (VHIO), Hematology Department, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain (Fenaux) Service d'Hematologie Seniors, Hopital Saint-Louis, Universite Paris 7, Paris, France (Shortt) Monash University and Monash Health, Melbourne, VIC, Australia (Komrokji) Moffitt Cancer Center, Tampa, FL, United States |
Presentation/Conference Date: | 27-Aug-2024 | Copyright year: | 2024 | Publisher: | Elsevier Inc. | Publication information: | Clinical Lymphoma, Myeloma and Leukemia. Conference: Proceedings of the Society of Hematologic Oncology 2024. GRB Convention Center, Houston United States. 24(Supplement 1) (pp S387-S388), 2024. Date of Publication: September 2024. | Journal: | Clinical Lymphoma, Myeloma and Leukemia | Abstract: | Context: There is an unmet need for effective treatments that provide durable benefit for patients with anemia due to lower-risk (LR) MDS. Objective(s): To report clinically meaningful responses to luspatercept treatment in TD, ESA-naive patients with LR-MDS (COMMANDS; NCT03682536). Patient(s): Adults (>=18 years) with LR-MDS (with or without ring sideroblasts) and <5% bone marrow blasts requiring RBC transfusions, endogenous serum erythropoietin <500 U/L, ESA-naive. Intervention(s): Patients (randomized 1:1) received luspatercept (1.0-1.75 mg/kg) Q3W or epoetin alfa (EA; 450-1050 IU/kg) QW for >=24 weeks. Result(s): As of March 31, 2023, 151/182 (83.0%) luspatercept-treated and 121/181 (66.9%) EA-treated patients received >=50% fewer RBC units transfused over >=12 weeks (week 1 to end of treatment; P = .0002); median (95% CI) durations were 130.0 (120.6-not evaluable [NE]) and 77.0 (54.9-123.1) weeks, respectively (P = .0004). More luspatercept than EA patients achieved this level of reduction regardless of baseline transfusion burden: 105/118 (89.0%) luspatercept vs 82/111 (73.9%) EA patients requiring <4 RBC units/8 weeks and 46/64 (71.9%) luspatercept vs 39/70 (55.7%) EA patients requiring >=4 RBC units/8 weeks. Median (interquartile range) number of RBC units transfused (weeks 1-24) was 1.0 (0-5.0) for luspatercept and 3.0 (0-8.0) for EA. Median (95% CI) time to RBC transfusion after treatment initiation was 155.0 (80.0-266.0) days for luspatercept vs 42.0 (23.0-55.0) days for EA (P < .0001). Among patients who achieved RBC transfusion independence (RBC-TI) >=12 weeks (weeks 1-24), 22/124 (17.7%) luspatercept vs 12/88 (13.6%) EA patients achieved >=2 separate responses; cumulative median (95% CI) duration of all response episodes was 147.9 (122.0-NE) weeks for luspatercept and 95.1 (73.1-NE) weeks for EA (P = .0067). Mean hemoglobin increase >=1.5 g/dL (weeks 1-24) was achieved by 135/182 (74.2%) luspatercept and 95/181 (52.5%) EA patients (P < .0001). Conclusion(s): More luspatercept versus EA patients achieved hemoglobin level improvements, reductions in transfusion burden and RBC units transfused, and had durable RBC-TI responses, supporting luspatercept use as the preferred treatment for ESA-naive patients with LR-MDS-associated anemia. Acknowledgement: ©2024 American Society of Clinical Oncology, Inc. Reused with permission. This abstract was accepted and previously presented at the 2024 ASCO Annual Meeting. All rights reserved.Copyright © 2024 Elsevier Inc. | Conference Name: | Proceedings of the Society of Hematologic Oncology 2024 | Conference Start Date: | 2024-09-04 | Conference End Date: | 2024-09-07 | Conference Location: | GRB Convention Center, Houston, United States | DOI: | http://monash.idm.oclc.org/login?url=https://dx.doi.org/10.1016/S2152-2650%2824%2901346-6 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/52340 | Type: | Conference Abstract | Subjects: | anemia hemoglobin blood level myelodysplastic syndrome |
Type of Clinical Study or Trial: | Clinical trial |
Appears in Collections: | Conferences |
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