COMMANDS Trial Data Update: Do the New Data Change Luspatercept’s Place in First-Line MDS Care?

Blood Cancers Today hosted a virtual roundtable of clinical experts in myelodysplastic syndromes (MDS) management. This expert panel’s discussion focused on describing how low-risk disease is managed today and assessing the impact from new research presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, held in Chicago, Illinois.

The panel, moderated by Saeed Sadeghi, MD, of UCLA Health in Santa Monica, California, was joined by Clark Alsfeld, MD, of Ochsner MD Anderson Cancer Center in Jefferson, Louisiana, Thomas W. LeBlanc, MD, MA, of Duke Health in Durham, North Carolina, and Raji Shameem, MD, of Orlando Health Cancer Institute in Lake Mary, Florida.

COMMANDS was a phase 3, randomized clinical trial, which compared luspatercept with epoetin alfa as treatment for anemia in patients with erythropoiesis-stimulating agent (ESA)–naive, red blood cell transfusion–dependent, lower-risk MDS. Luspatercept performed impressively in the trial, and the agent has since been at the forefront of clinicians’ first-line management approaches for low-risk MDS.

Updated COMMANDS trial efficacy and safety data were presented at the ASCO Annual Meeting and have been reviewed by the expert panel. In this segment of their roundtable discussion, the panelists give their impressions of these data and talk about whether the update affects their view of luspatercept’s role in MDS care, especially relative to ESAs.