Efficacy and safety of ruxolitinib in patients with newly-diagnosed polycythemia vera: futility analysis of the RuxoBEAT clinical trial of the GSG-MPN study group

Ann Hematol. 2023 Feb;102(2):349-358. doi: 10.1007/s00277-022-05080-7. Epub 2022 Dec 23.

Abstract

Patients (pts) with polycythemia vera (PV) suffer from pruritus, night sweats, and other symptoms, as well as from thromboembolic complications and progression to post-PV myelofibrosis. Ruxolitinib (RUX) is approved for second-line therapy in high-risk PV pts with hydroxyurea intolerance or resistance. The RuxoBEAT trial (NCT02577926, registered on October 1, 2015, at clinicaltrials.gov) is a multicenter, open-label, two-arm phase-IIb trial with a target population of 380 pts with PV or ET, randomized to receive RUX or best available therapy. This pre-specified futility analysis assesses the early clinical benefit and tolerability of RUX in previously untreated PV pts (6-week cytoreduction was allowed). Twenty-eight patients were randomly assigned to receive RUX. Compared to baseline, after 6 months of treatment, there was a significant reduction of median hematocrit (46 to 41%), the median number of phlebotomies per year (4.0 to 0), and median patient-reported pruritus scores (2 to 1), and a trend for reduced night sweat scores (1.5 to 0). JAK2V617F allele burden, as part of the scientific research program, also significantly decreased. One hundred nine adverse events (AEs) occurred in 24/28 patients (all grade 1 to 3), and no pt permanently discontinued treatment because of AEs. Thus, treatment with ruxolitinib in untreated PV pts is feasible, well-tolerated, and efficient regarding the above-mentioned endpoints.

Keywords: Best available therapy; Efficacy and safety; German Study Group for myeloproliferative neoplasms (GSG-MPN); Polycythemia vera (PV); Randomized clinical trial; Ruxolitinib.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Humans
  • Hydroxyurea / therapeutic use
  • Janus Kinases* / therapeutic use
  • Medical Futility
  • Nitriles / therapeutic use
  • Polycythemia Vera* / diagnosis
  • Polycythemia Vera* / drug therapy
  • Polycythemia Vera* / genetics
  • Pyrimidines / therapeutic use

Substances

  • Hydroxyurea
  • Nitriles
  • Pyrimidines
  • ruxolitinib
  • Janus Kinases
  • JAK2 protein, human

Associated data

  • ClinicalTrials.gov/NCT02577926