Prescriber's Corner
Role of Luspatercept in the Management of Lower-Risk Myelodysplastic Syndromes
Sara M. Tinsley-Vance,(1) PhD, APRN, AOCN®, Mark Davis,(2) MPAS, PA-C, and Olalekan Ajayi,(3) PharmD, MBA
From (1)Moffitt Cancer Center, Tampa, Florida; (2)Texas Oncology-Southwest Fort Worth, Fort Worth, Texas; (3)Highlands Oncology Group, Rogers, Arkansas
Authors’ disclosures of conflicts of interest are found at the end of this article.
Correspondence to: Sara M. Tinsley-Vance,
PhD, APRN, AOCN®, Moffitt Cancer Center,
12902 Magnolia Drive, Tampa, FL 33612
E-mail: sara.tinsleyvance@moffitt.org
J Adv Pract Oncol 2023;14(1):82–87 |
https://doi.org/10.6004/jadpro.2023.14.1.8 |
© 2023 Harborside™
ABSTRACT
Treatment options are limited for patients with anemia associated with lower-risk myelodysplastic syndromes (LR-MDS). The recent approval of luspatercept for the treatment of anemia associated with very low- to intermediate-risk MDS with ring sideroblasts (RS) or with myelodysplastic/myeloproliferative neoplasm with RS and thrombocytosis has provided adult patients and practitioners with a much-needed new therapeutic option. Luspatercept is a first-in-class erythroid maturation agent that exerts its effects on later stages of erythropoiesis. In the phase III MEDALIST trial of patients with LR-MDS with RS, luspatercept (starting dose 1 mg/kg) demonstrated substantial clinical benefit (38% of patients treated with luspatercept vs. 13% of those treated with placebo [p < .001] achieved transfusion independence for ≥ 8 weeks during the first 24 weeks of treatment) and a favorable safety profile. The most common adverse events (AEs), including fatigue, asthenia, dizziness, and diarrhea, were more frequent during the first 4 treatment cycles and subsequently declined. This review provides a comprehensive overview of luspatercept treatment administration, including the mechanism of action, efficacy and safety data, management of dosing, and AEs associated with luspatercept treatment of patients with LR-MDS.
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