Key Findings Presented at ASCO 2025
Long-term follow-up data from the COMMANDS trial were presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting. The key findings reinforce and build upon earlier results, demonstrating the sustained superiority of luspatercept over ESA
Sustained Efficacy and Durability:
Luspatercept showed a greater and more durable clinical benefit. A significantly higher percentage of patients on luspatercept achieved red blood cell transfusion independence (RBC-TI) for 12 weeks or longer (76% vs 56%). The median duration of the longest transfusion independence was also substantially longer with luspatercept (127 weeks) compared to epoetin alfa (87 weeks). The median cumulative duration of transfusion independence was 187.3 weeks for luspatercept vs 94.9 weeks for epoetin alfa.
Overall Survival (OS):
A trend toward improved overall survival was observed with luspatercept. The median OS was not reached in the luspatercept group, while it was 46.7 months in the epoetin alfa group. This survival benefit was consistent across various patient subgroups, regardless of their ring sideroblast status, baseline erythropoietin levels, or transfusion burden.
Safety Profile:
The trial’s long-term follow-up confirmed that luspatercept’s safety profile is consistent with its known profile, with no new safety concerns emerging. The rates of disease progression to acute leukemia were low and similar in both treatment groups (around 4-5%), suggesting the survival benefit may be due to mechanisms beyond just preventing disease progression.
Treatment Continuation and Dose Escalation:
A greater proportion of patients remained on luspatercept therapy compared to epoetin alfa (22% vs 10%). The data also indicated that dose escalation is a common and often effective part of the luspatercept treatment journey, with approximately 85% of patients in that arm requiring at least one dose escalation.