Srdan Verstovsek, MD, PhD, a professor, Department of Leukemia, Division of Cancer Medicine, director, Hanns A. Pielenz Clinical Research Center for Myeloproliferative Neoplasms, and chief, Section for Myeloproliferative Neoplasms, Department of Leukemia at the University of Texas MD Anderson Cancer Center, discusses the impacts of an analysis demonstrating longer survival in patients with myelofibrosis who received ruxolitinib (Jakafi) versus those who didn’t.
The real benefits in every practice that used ruxolitinib are improving quality-of-life and decrease in spleen size, according to Verstovsek. With a longer-term follow up, there was prolongation of life. Verstovsek says it was questionable because the study so far did not have the primary aim to prolong survival and the survival benefit was discovered during a post hoc analysis.
Verstovsek feels there is some worry about physicians not endorsing that benefit. The data presented at the 2020 American Society of Hematology Annual Meeting may have changed the mind of the treating physicians in a community setting from focusing only on a quality-of-life and the degree of a spleen reduction to prolongation of life. The understanding of that benefit will lead to better improvement in the spleen response, he hopes.
The degree of spleen reduction correlated well with the prolongation of life in other studies published. Changing focus from improving quality-of-life, which is valuable, to controlling the spleen size in a safe way during the first 6 months of therapy may lead to prolongation of life at some point, says Verstovsek. He also thinks these data will enhance understanding of that benefit and hopes it will improve the management of patients.