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Spleen volume reduction and transfusion independence with momelotinib versus ruxolitinib and associated overall survival with momelotinib in JAK inhibitor-naive patients with myelofibrosis and anemia: subgroup analyses of SIMPLIFY-1

Introduction - Improvements in splenomegaly, anemia, and overall survival (OS) are key considerations in the management of patients with myelofibrosis. In the phase III SIMPLIFY-1 trial (NCT01969838), momelotinib was noninferior to ruxolitinib for spleen volume reduction ≥ 35% (SVR35) and nominally...

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Autori principali: Palandri, Francesca (Autore) , Schaap, Nicolaas P. M. (Autore) , Rey, Jerome (Autore) , von Bubnoff, Nikolas (Autore) , Reiter, Andreas (Autore) , Hernandez-Boluda, Juan Carlos (Autore) , Devos, Timothy (Autore) , Nilsson, Lars (Autore) , Psaila, Bethan (Autore) , McLornan, Donal P. (Autore) , Strouse, Bryan (Autore) , Zhang, Shiyuan (Autore) , Patel, Bharat (Autore) , Lim, Jessica (Autore) , Patnaik, Dwaipayan (Autore) , Oh, Stephen T. (Autore)
Natura: Article (Journal)
Lingua:inglese
Pubblicazione: May 2026
In: Clinical lymphoma, myeloma & leukemia
Year: 2026, Volume: 26, Fascicolo: 5, Pages: 297-308.e1
ISSN:2152-2669
DOI:10.1016/j.clml.2026.02.004
Accesso online:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.clml.2026.02.004
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S215226502600039X
Testo
Note sull'autore:Francesca Palandri, Nicolaas P.M. Schaap, Jerome Rey, Nikolas von Bubnoff, Andreas Reiter, Juan Carlos Hernandez-Boluda, Timothy Devos, Lars Nilsson, Bethan Psaila, Donal P. McLornan, Bryan Strouse, Shiyuan Zhang, Bharat Patel, Jessica Lim, Dwaipayan Patnaik, Stephen T. Oh
Descrizione
Riassunto:Introduction - Improvements in splenomegaly, anemia, and overall survival (OS) are key considerations in the management of patients with myelofibrosis. In the phase III SIMPLIFY-1 trial (NCT01969838), momelotinib was noninferior to ruxolitinib for spleen volume reduction ≥ 35% (SVR35) and nominally superior for transfusion independence (TI) at week 24 in Janus kinase (JAK) inhibitor-naive patients. However, the relative impact of these endpoints on OS in anemic patients has not been described. - Materials and Methods - The present post hoc analysis evaluated week 24 SVR35, TI, and dual responses (SVR35 + TI) in patients with baseline hemoglobin < 10 g/dL. - Results - SVR35 rates were similar overall with momelotinib versus ruxolitinib (27/86 [31%] vs. 31/94 [33%]), but higher with momelotinib in the baseline platelets < 200 × 109/L subgroup (19/49 [39%] vs. 8/47 [17%]) and with ruxolitinib in the baseline platelets ≥ 200 × 109/L subgroup (8/37 [22%] vs. 23/47 [49%]). Week 24 SVR35 + TI was also more common with momelotinib (23/86 [27%]) than with ruxolitinib (7/94 [7%]). Subsequent OS analysis focused on the momelotinib arm only, as the crossover trial design precluded analysis of long-term OS with ruxolitinib. OS was longer in patients who were transfusion independent and/or achieved SVR35 at week 24 versus those who met neither endpoint (TI alone: n = 17, hazard ratio [HR], 0.25 [95% CI, 0.09-0.70]; SVR35 + TI: n = 23, HR, 0.40 [95% CI, 0.18-0.87]). - Conclusion - These results highlight that both spleen- and anemia-related benefits of momelotinib correlate with improved OS, supporting prioritization of TI in anemic patients for optimal long-term outcomes, and suggest that momelotinib may be the preferred JAK inhibitor in anemic patients with platelets < 200 × 109/L.
Descrizione del documento:Online verfügbar: 14. Februar 2026, Artikelversion: 6. Mai 2026
Gesehen am 07.07.2026
Descrizione fisica:Online Resource
ISSN:2152-2669
DOI:10.1016/j.clml.2026.02.004

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