MEDALIST: Clinical Implications in Lower-Risk MDS
Clinicians review the MEDALIST trial, which evaluated luspatercept in the second-line setting and comment on updated data from MEDALIST that was recently presented at the annual ASH 2023 meeting.
This is a video synopsis/summary of a Precision Medicine series featuring Hana Safah, MD, and Jamie Koprivnikar, MD.
Drs Safah and Koprivnikar review American Society of Hematology (ASH) abstracts regarding recently approved therapies like luspatercept and potential new approaches for managing myelodysplastic syndromes (MDS).
Full results from the phase 3 COMMANDS trial confirm luspatercept’s benefit over epoetin alfa, with additional analyses demonstrating quality-of-life improvements, likely related to less frequent dosing and treatment burden. Other data reveal a decrease in pro–B-type natriuretic peptide levels, suggesting possible cardiovascular benefits, and differences in response kinetics based on ring sideroblast (RS) status. RS-negative patients exhibit a slower yet steady deepening response over 48 weeks, supporting longer treatment duration in this subgroup.
These insights indicate disease-modifying properties beyond hematologic changes, impacting inflammatory mediators implicated in MDS-related anemia. This represents a shift from pure symptomatic treatment toward targeting underlying disease processes.
Additional research may uncover optimal sequencing strategies, such as combining agents earlier to maximize responses in certain molecular subgroups. However, currently available and emerging therapies herald an exciting new era of improving care and outcomes in this predominantly elderly population.
Video synopsis is AI-generated and reviewed by Targeted Oncology® editorial staff.
