Clinical benefit and predictors of response to momelotinib after ruxolitinib failure: A cooperative real-world study - PubMed
3 hours ago
- #Momelotinib
- #Myelofibrosis
- #Real-world study
- Momelotinib, a JAK1/JAK2/ACVR1 inhibitor, is approved for treating myelofibrosis with splenomegaly, symptoms, and anemia.
- This real-world study analyzed 221 myelofibrosis patients who received momelotinib after ruxolitinib failure, assessing spleen, symptom, and anemia responses, safety, and survival.
- Patients had received ruxolitinib for a median of 31.5 months before switching, discontinuing due to resistance, intolerance, or both, with most (74.7%) transitioning within 2 months without tapering.
- At baseline, 97.3% of patients had cytopenia, 34.8% had large splenomegaly, and 43.9% were highly symptomatic, all starting momelotinib at full dose.
- Adverse events occurred in 35.7% of patients after a median exposure of 8.2 months, leading to dose reductions in 12.7% and discontinuation in 19.9%.
- At 6 months, 30.0% achieved a spleen length reduction of ≥50%, with better responses in those with prior ruxolitinib spleen response and shorter transition intervals.
- Symptom and anemia responses were observed in 39.2% and 63.4% of patients, respectively.
- After a median follow-up of 10.3 months, 5.0% progressed to blast phase and 16.7% died, with 2-year overall survival at 60.9% and progression-free survival at 59.0%.
- Momelotinib demonstrated meaningful clinical benefit and acceptable safety in cytopenic patients post-ruxolitinib failure, supporting its role in this setting.