Dr. Garcia on the Tolerability of Navitoclax/Ruxolitinib in Myelofibrosis

Jacqueline S. Garcia, MD
Published: Tuesday, Feb 25, 2020



Jacqueline S. Garcia, MD, instructor in medicine, Department of Medical Oncology, Harvard Medical School, and physician, Dana-Farber Cancer Institute, discusses the tolerability of the combination of navitoclax plus ruxolitinib (Jakafi) in patients with myelofibrosis.

Half of the patients with high-risk molecular mutations had ≥2 mutations, explains Garcia. Data suggest that the more mutations a patient has, the more resistant they will be to therapy. A spleen volume response (SVR) was seen in 43% of patients and responses could have occurred beyond 6 months, suggesting that with longer follow-up, there might be an improvement in SVR, says Garcia. Assessments and paired questionnaires showed that total symptom score was reduced in 65% of patients from week 24 compared with baseline.

Furthermore, patients found the regimen tolerable. The combination showed evidence of thrombocytopenia, fatigue, and diarrhea but most were low grade. There was 1 patient with isolated grade 4 thrombocytopenia, but it was reversible with a temporary dose hold and the patient was able to resume therapy, concludes Garcia.
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Jacqueline S. Garcia, MD, instructor in medicine, Department of Medical Oncology, Harvard Medical School, and physician, Dana-Farber Cancer Institute, discusses the tolerability of the combination of navitoclax plus ruxolitinib (Jakafi) in patients with myelofibrosis.

Half of the patients with high-risk molecular mutations had ≥2 mutations, explains Garcia. Data suggest that the more mutations a patient has, the more resistant they will be to therapy. A spleen volume response (SVR) was seen in 43% of patients and responses could have occurred beyond 6 months, suggesting that with longer follow-up, there might be an improvement in SVR, says Garcia. Assessments and paired questionnaires showed that total symptom score was reduced in 65% of patients from week 24 compared with baseline.

Furthermore, patients found the regimen tolerable. The combination showed evidence of thrombocytopenia, fatigue, and diarrhea but most were low grade. There was 1 patient with isolated grade 4 thrombocytopenia, but it was reversible with a temporary dose hold and the patient was able to resume therapy, concludes Garcia.



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