Cancer Medicine (Apr 2023)

Assessment of the efficacy and tolerability of ruxolitinib for the treatment of myelofibrosis patients in a real‐life setting: An Italian MYNERVA Project

  • Giacomo Coltro,
  • Emanuela Sant'Antonio,
  • Giuseppe A. Palumbo,
  • Francesco Mannelli,
  • Valerio De Stefano,
  • Marco Ruggeri,
  • Elena M. Elli,
  • Roberta Zanotti,
  • Oscar Borsani,
  • Irene Bertozzi,
  • Andrea Duminuco,
  • Silvia Betti,
  • Giuseppe Carli,
  • Fabrizio Cavalca,
  • Ilaria Tanasi,
  • Elisa Rumi,
  • Maria L. Randi,
  • Bruno Garibaldi,
  • Giuseppe G. Loscocco,
  • Paola Guglielmelli,
  • Alessandro M. Vannucchi

DOI
https://doi.org/10.1002/cam4.5618
Journal volume & issue
Vol. 12, no. 7
pp. 8166 – 8171

Abstract

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Abstract Background Incorporating real‐world data in the drug development process allows the improvement of health outcomes by providing better representation of actual patterns of drug safety and efficacy. Aims and Methods Here, we present the results of a retroprospective, observational real‐life study of 154 patients with myelofibrosis treated with ruxolitinib in a real‐life setting in seven Italian centers of the MYNERVA project. Results Median drug exposure was 29 (range, 3–98) months. Discontinuation rate was 27% after a median time of 13 (range, 3–61). While hematological toxicities were in line with previous findings, infections occurred frequently, representing a not negligible cause of discontinuation and death. Anemia, symptoms, and spleen responses were obtained at any time in 23%, 91%, and 68% of patients, respectively; most patients achieved their responses by week 24. Larger splenomegaly and delayed treatment initiation correlated with lower spleen response at 24 weeks. Spleen response was associated with a superior overall survival, regardless of DIPSS. Of interest, both achievement and loss of spleen response had prognostic implications. Discussion and Conclusion Overall, our findings provide insights on the efficacy and safety of ruxolitinib in a real‐world, multicenter cohort of Italian MF patients.

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