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Cancers & treatments·Sequencing

Lower-risk myelodysplastic syndromes: lines of therapy

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4 standard-of-care settings across 3 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comers
Advanced, first line1
Special situations1
Other settings2

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersAnaemia, first lineLuspatercept for ring-sideroblast or SF3B1-mutated disease and for transfusion-dependent patients (COMMANDS); erythropoiesis-stimulating agent where serum erythropoietin is below 500 U/L; lenalidomide for del(5q).
LuspaterceptEpoetin alfaDarbepoetin alfaLenalidomide
91

Special situations

SubgroupSettingApproachProducts and trialsEvidence
All comersSupportive careRed cell transfusion to symptoms, iron chelation once ferritin is persistently high, G-CSF for recurrent neutropenic infection, platelet transfusion for bleeding.
Transfusion support and anaemia managementGrowth factors: G-CSF and febrile neutropenia prevention
84

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersAsymptomatic, no transfusionsObservation with blood counts every three to six months; no treatment.
Transfusion support and anaemia management
84
All comersAnaemia after erythropoietin or luspatercept failureImetelstat (IMerge); luspatercept if not yet used; low-dose hypomethylating agent; trials of elritercept and other agents.
ImetelstatLuspaterceptAzacitidineA Study of Elritercept to Treat Anemia in Adults With Very Low, Low, or Intermediate Risk Myelodysplastic Syndromes (MDS) Who Need Regular BStudy of R289 in Patients With Lower-risk Myelodysplastic Syndromes (LR MDS)RVU120 for Treatment of Anemia in Patients With Lower-risk Myelodysplastic Neoplasms
89

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.