Transcript
Hi there, I'm Lindsay Kalhagen. I am a physician assistant at Northwestern Medicine in Chicago in the benign hematology department, and I am going to be talking about one of the poster abstracts from ASH from this year titled, Outcomes Are Similar for Combination Interferon and Ruxolitinib Versus Ruxolitinib and Myelofibrosis, A Propensity Score Match Study. So as many of us know, combining ruxolitinib and interferon has been thought to enhance clinical benefit and potentially have a positive impact on reducing this malignant clone. The question that this team asked out of Cornell was, does this combination therapy of ruxolitinib plus interferon versus ruxolitinib alone ultimately improve longer-term outcomes like progression-free survival as well as overall survival? So this was a single-center retrospective study to compare this. So 62 patients, it was 31 patients on ruxolitinib plus interferon versus 31 patients on ruxolitinib alone. Medium follow-up time was 5.9 years, and the time from when they all were started on therapy was the same in both arms. For the combo arm for ruxolitinib plus interferon, for some of them they were on interferon first and RUX was an add-on. For some they were on RUX first and interferon was an add-on, and for some of them they were simultaneously started both at the same time.
And of course with these therapies, the thought was can this not only improve clinical response, but also is there an impact, a disease-modifying benefit with the combination therapy? What they saw was between the two that discontinuation rates were pretty similar, most of them being discontinued for adverse events from the medication themselves. Unfortunately, median progression-free survival was not reached, and they ultimately did not see a significant difference between ruxolitinib alone versus ruxolitinib plus interferon in progression-free survival, median overall survival was 9.7 years and again, did not show any advantage to combination therapy. Clinical responses in both were similar, about a little over a third of patients actually had a clinical benefit to combo therapy versus RUX alone. But again, unfortunately no differences seen in spleen response, molecular response, or actually bone marrow response. So there was no difference in reticulating-grade reduction in 28 of these patients who had serial marrow.
And so what I took from this and thought about this was a little disappointing, unfortunately, to see with what we know about interferon, that the addition of it was not at least in this compared group showing a significant benefit. And this group took away from it also, as far as that both of them were equally well-tolerated, safety profile is similar, but ultimately, again, that there was no significant improvement in overall survival or progression-free survival in the combo therapy. And so really thinking about is combo therapy appropriate from a cost perspective with what we know about it? And I think, again, just really highlighting for us going forward that that is helpful for us as providers that again, we're always looking to see not only how can we improve clinical benefits for patients, but also disease-modifying benefits and having ongoing information and studies, looking at this is really helpful as far as discussing with patients and thinking about what our next steps are for clinicians for treatment of myelofibrosis and looking forward to more studies looking into this even further.
