Ruxolitinib reduces JAK2 p.V617F allele burden in patients with polycythemia vera enrolled in the RESPONSE study

In patients with polycythemia vera (PV), an elevated JAK2 p.V617F allele burden is associated with indicators of more severe disease (e.g., leukocytosis, splenomegaly, and increased thrombosis risk); however, correlations between allele burden reductions and clinical benefit in patients with PV have...

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Veröffentlicht in:Annals of hematology 2017-07, Vol.96 (7), p.1113-1120
Hauptverfasser: Vannucchi, Alessandro Maria, Verstovsek, Srdan, Guglielmelli, Paola, Griesshammer, Martin, Burn, Timothy C., Naim, Ahmad, Paranagama, Dilan, Marker, Mahtab, Gadbaw, Brian, Kiladjian, Jean-Jacques
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container_end_page 1120
container_issue 7
container_start_page 1113
container_title Annals of hematology
container_volume 96
creator Vannucchi, Alessandro Maria
Verstovsek, Srdan
Guglielmelli, Paola
Griesshammer, Martin
Burn, Timothy C.
Naim, Ahmad
Paranagama, Dilan
Marker, Mahtab
Gadbaw, Brian
Kiladjian, Jean-Jacques
description In patients with polycythemia vera (PV), an elevated JAK2 p.V617F allele burden is associated with indicators of more severe disease (e.g., leukocytosis, splenomegaly, and increased thrombosis risk); however, correlations between allele burden reductions and clinical benefit in patients with PV have not been extensively evaluated in a randomized trial. This exploratory analysis from the multicenter, open-label, phase 3 Randomized Study of Efficacy and Safety in Polycythemia Vera With JAK Inhibitor INCB018424 Versus Best Supportive Care trial evaluated the long-term effect of ruxolitinib treatment on JAK2 p.V617F allele burden in patients with PV. Evaluable JAK2 p.V617F-positive patients randomized to ruxolitinib ( n  = 107) or best available therapy (BAT) who crossed over to ruxolitinib at week 32 ( n  = 97) had consistent JAK2 p.V617F allele burden reductions throughout the study. At all time points measured (up to weeks 208 [ruxolitinib-randomized] and 176 [ruxolitinib crossover]), mean changes from baseline over time in JAK2 p.V617F allele burden ranged from −12.2 to −40.0% (ruxolitinib-randomized) and −6.3 to −17.8% (ruxolitinib crossover). Complete or partial molecular response was observed in 3 patients (ruxolitinib-randomized, n  = 2; ruxolitinib crossover, n  = 1) and 54 patients (ruxolitinib-randomized, n  = 33; ruxolitinib crossover, n  = 20; BAT, n  = 1), respectively. Among patients treated with interferon as BAT ( n  = 13), the mean maximal reduction in allele burden from baseline was 25.6% after crossover to ruxolitinib versus 6.6% before crossover. Collectively, the data from this exploratory analysis suggest that ruxolitinib treatment for up to 4 years provides progressive reductions in JAK2 p.V617F allele burden in patients with PV who are resistant to or intolerant of hydroxyurea. The relationship between allele burden changes and clinical outcomes in patients with PV remains unclear.
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This exploratory analysis from the multicenter, open-label, phase 3 Randomized Study of Efficacy and Safety in Polycythemia Vera With JAK Inhibitor INCB018424 Versus Best Supportive Care trial evaluated the long-term effect of ruxolitinib treatment on JAK2 p.V617F allele burden in patients with PV. Evaluable JAK2 p.V617F-positive patients randomized to ruxolitinib ( n  = 107) or best available therapy (BAT) who crossed over to ruxolitinib at week 32 ( n  = 97) had consistent JAK2 p.V617F allele burden reductions throughout the study. At all time points measured (up to weeks 208 [ruxolitinib-randomized] and 176 [ruxolitinib crossover]), mean changes from baseline over time in JAK2 p.V617F allele burden ranged from −12.2 to −40.0% (ruxolitinib-randomized) and −6.3 to −17.8% (ruxolitinib crossover). Complete or partial molecular response was observed in 3 patients (ruxolitinib-randomized, n  = 2; ruxolitinib crossover, n  = 1) and 54 patients (ruxolitinib-randomized, n  = 33; ruxolitinib crossover, n  = 20; BAT, n  = 1), respectively. Among patients treated with interferon as BAT ( n  = 13), the mean maximal reduction in allele burden from baseline was 25.6% after crossover to ruxolitinib versus 6.6% before crossover. Collectively, the data from this exploratory analysis suggest that ruxolitinib treatment for up to 4 years provides progressive reductions in JAK2 p.V617F allele burden in patients with PV who are resistant to or intolerant of hydroxyurea. 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This exploratory analysis from the multicenter, open-label, phase 3 Randomized Study of Efficacy and Safety in Polycythemia Vera With JAK Inhibitor INCB018424 Versus Best Supportive Care trial evaluated the long-term effect of ruxolitinib treatment on JAK2 p.V617F allele burden in patients with PV. Evaluable JAK2 p.V617F-positive patients randomized to ruxolitinib ( n  = 107) or best available therapy (BAT) who crossed over to ruxolitinib at week 32 ( n  = 97) had consistent JAK2 p.V617F allele burden reductions throughout the study. At all time points measured (up to weeks 208 [ruxolitinib-randomized] and 176 [ruxolitinib crossover]), mean changes from baseline over time in JAK2 p.V617F allele burden ranged from −12.2 to −40.0% (ruxolitinib-randomized) and −6.3 to −17.8% (ruxolitinib crossover). Complete or partial molecular response was observed in 3 patients (ruxolitinib-randomized, n  = 2; ruxolitinib crossover, n  = 1) and 54 patients (ruxolitinib-randomized, n  = 33; ruxolitinib crossover, n  = 20; BAT, n  = 1), respectively. Among patients treated with interferon as BAT ( n  = 13), the mean maximal reduction in allele burden from baseline was 25.6% after crossover to ruxolitinib versus 6.6% before crossover. Collectively, the data from this exploratory analysis suggest that ruxolitinib treatment for up to 4 years provides progressive reductions in JAK2 p.V617F allele burden in patients with PV who are resistant to or intolerant of hydroxyurea. 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Verstovsek, Srdan ; Guglielmelli, Paola ; Griesshammer, Martin ; Burn, Timothy C. ; Naim, Ahmad ; Paranagama, Dilan ; Marker, Mahtab ; Gadbaw, Brian ; Kiladjian, Jean-Jacques</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-dc45214f21486a450f6948a7afc602c1d07c0eecf9a7655721db82a030a0d25b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alleles</topic><topic>Blood cancer</topic><topic>Cross-Over Studies</topic><topic>Female</topic><topic>Gene Frequency</topic><topic>Hematology</topic><topic>Humans</topic><topic>Inhibitor drugs</topic><topic>Janus Kinase 2 - antagonists &amp; inhibitors</topic><topic>Janus Kinase 2 - genetics</topic><topic>Janus Kinase 2 - metabolism</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Middle Aged</topic><topic>Mutation, Missense</topic><topic>Oncology</topic><topic>Original</topic><topic>Original Article</topic><topic>Polycythemia Vera - drug therapy</topic><topic>Polycythemia Vera - enzymology</topic><topic>Polycythemia Vera - genetics</topic><topic>Pyrazoles - therapeutic use</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vannucchi, Alessandro Maria</creatorcontrib><creatorcontrib>Verstovsek, Srdan</creatorcontrib><creatorcontrib>Guglielmelli, Paola</creatorcontrib><creatorcontrib>Griesshammer, Martin</creatorcontrib><creatorcontrib>Burn, Timothy C.</creatorcontrib><creatorcontrib>Naim, Ahmad</creatorcontrib><creatorcontrib>Paranagama, Dilan</creatorcontrib><creatorcontrib>Marker, Mahtab</creatorcontrib><creatorcontrib>Gadbaw, Brian</creatorcontrib><creatorcontrib>Kiladjian, Jean-Jacques</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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however, correlations between allele burden reductions and clinical benefit in patients with PV have not been extensively evaluated in a randomized trial. This exploratory analysis from the multicenter, open-label, phase 3 Randomized Study of Efficacy and Safety in Polycythemia Vera With JAK Inhibitor INCB018424 Versus Best Supportive Care trial evaluated the long-term effect of ruxolitinib treatment on JAK2 p.V617F allele burden in patients with PV. Evaluable JAK2 p.V617F-positive patients randomized to ruxolitinib ( n  = 107) or best available therapy (BAT) who crossed over to ruxolitinib at week 32 ( n  = 97) had consistent JAK2 p.V617F allele burden reductions throughout the study. At all time points measured (up to weeks 208 [ruxolitinib-randomized] and 176 [ruxolitinib crossover]), mean changes from baseline over time in JAK2 p.V617F allele burden ranged from −12.2 to −40.0% (ruxolitinib-randomized) and −6.3 to −17.8% (ruxolitinib crossover). Complete or partial molecular response was observed in 3 patients (ruxolitinib-randomized, n  = 2; ruxolitinib crossover, n  = 1) and 54 patients (ruxolitinib-randomized, n  = 33; ruxolitinib crossover, n  = 20; BAT, n  = 1), respectively. Among patients treated with interferon as BAT ( n  = 13), the mean maximal reduction in allele burden from baseline was 25.6% after crossover to ruxolitinib versus 6.6% before crossover. Collectively, the data from this exploratory analysis suggest that ruxolitinib treatment for up to 4 years provides progressive reductions in JAK2 p.V617F allele burden in patients with PV who are resistant to or intolerant of hydroxyurea. The relationship between allele burden changes and clinical outcomes in patients with PV remains unclear.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28456851</pmid><doi>10.1007/s00277-017-2994-x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Alleles
Blood cancer
Cross-Over Studies
Female
Gene Frequency
Hematology
Humans
Inhibitor drugs
Janus Kinase 2 - antagonists & inhibitors
Janus Kinase 2 - genetics
Janus Kinase 2 - metabolism
Male
Medicine
Medicine & Public Health
Middle Aged
Mutation, Missense
Oncology
Original
Original Article
Polycythemia Vera - drug therapy
Polycythemia Vera - enzymology
Polycythemia Vera - genetics
Pyrazoles - therapeutic use
Time Factors
Treatment Outcome
title Ruxolitinib reduces JAK2 p.V617F allele burden in patients with polycythemia vera enrolled in the RESPONSE study
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