Steroid-Refractory Chronic GVHD Requires More Treatment Options

May 14, 2020
Corey S. Cutler, MD, MPH, FRCPC

Corey S. Cutler, MD, MPH, discusses the current treatment options for patients with chronic graft-versus-host-disease and highlighted some upcoming research.

Corey S. Cutler, MD, MPH, medical director of the Stem Cell Transplant Program, Dana-Farber Cancer Institute, discusses the current treatment options for patients with chronic graft-versus-host-disease (GVHD) and highlighted some upcoming research.

Corticosteroids remains the mainstay of therapy in chronic GVHD, says Cutler. However, 50% to 60% of patients who receive steroids will become refractory within the first year of therapy, so there is another FDA-approved treatment available, which is the BTK inhibitor Ibrutinib (Imbruvica). This agent, which is approved for patients with steroid-refractory chronic GVHD, demonstrated a relatively impressive response rate around 60% in a small open-label phase II clinical trial.

Beyond ibrutinib, Cutler says there is no approved third-line option for patients with chronic GVHD. The most promising agent, however, is KD025, a ROCK2 inhibitor. He expects to hear more about this agent in the coming years, but a recent randomized phase II trial showed responses in approximately 65% of heavily pretreated patients. Cutler says experts anxiously await the final results of this study, and hopefully there will be an FDA approval to follow as well.

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