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Novel Therapies Reduce Symptom Burden, Result in Improved Survival in MPNs

Caroline Seymour
Published: Thursday, Apr 04, 2019

Terrence J. Bradley, MD

Terrence J. Bradley, MD

For patients with myelofibrosis (MF) and polycythemia vera (PV), symptom burden can take a toll on quality of life, explained Terrence J. Bradley, MD, an assistant professor at Sylvester Comprehensive Cancer Center, University of Miami Health System.

State of the Science Summit™ on Hematologic Malignancies.

Myelofibrosis

The frontline setting of myelofibrosis currently consists of hydroxyurea and ruxolitinib (Jakafi), said Bradley. With ruxolitinib, the phase III COMFORT-I trial was the first study to demonstrate a survival advantage in patients with MF. In the double-blind study, patients with intermediate-2 or high-risk disease (n = 309) were randomized to receive ruxolitinib or placebo. A reduction in spleen volume ≥35% as measured by CT or MRI served as the primary endpoint of the trial, with secondary endpoints of durability of response, symptom burden, and overall survival (OS). Though many patients experience blood count abnormalities and constitutional symptoms, enlarged spleens are a common cause of discomfort prompting the primary endpoint as such, said Bradley.

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Polycythemia Vera

For patients with PV who are not receiving phlebotomy but require pharmacologic therapy, hydroxyurea can be given as a first-line therapy after which ruxolitinib can be given as a second-line treatment alongside anagrelide and interferon, said Bradley.


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