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ASH 2024 | Results of a MAIC comparing OS with momelotinib versus BAT in ruxolitinib-experienced myelofibrosis
Francesca Palandri, MD, PhD, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy, comments on the findings of a matching-adjusted indirect comparison (MAIC) of momelotinib versus best available therapy (BAT) in patients with ruxolitinib-experienced myelofibrosis (MF). Dr Palandri highlights that momelotinib provides a greater overall survival (OS) benefit to BAT and that these results support the use of the agent as a standard of care (SoC) for those with anemia who have failed on ruxolitinib therapy. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript
This year at ASH 2024 we have presented an abstract called Overall Survival with Momelotinib versus Best Available Therapy in Patients with Ruxolitinib-Experienced Myelofibrosis and Matching Adjusted Indirect Comparison.
It is very well known that ruxolitinib is the main frontline therapy for intermediate and high-risk patients with myelofibrosis...
This year at ASH 2024 we have presented an abstract called Overall Survival with Momelotinib versus Best Available Therapy in Patients with Ruxolitinib-Experienced Myelofibrosis and Matching Adjusted Indirect Comparison.
It is very well known that ruxolitinib is the main frontline therapy for intermediate and high-risk patients with myelofibrosis. But, however, most patients will eventually discontinue ruxolitinib, and these patients have generally a very poor prognosis. So there is a significant need for a more effective and safe treatment after ruxolitinib discontinuation. And this new treatment should be able to improve long-term outcomes that include not only spleen and symptom responses, but also the improvement of overall survival. However, in our real-world practice, the timing of ruxolitinib discontinuation, but also the selection of the best second-line therapy may be very challenging, and it is important to collect data that may guide this difficult treatment decision.
Momelotinib is a JAK1 and JAK2 inhibitor like ruxolitinib, but it is also an ACVR1 inhibitor that is approved for the patient with intermediate to high-risk myelofibrosis with splenomegaly, symptoms and anemia. Unlike ruxolitinib and fedratinib, which are associated with significant drug-related anemia, momelotinib has shown anemia benefits and also symptoms and spleen responses across three Phase III trials, the SIMPLIFY-1, the SIMPLIFY-2 and the MOMENTUM trial.
In this particular study of ours, we compared the overall survival in patients with ruxolitinib-experienced myelofibrosis from the momelotinib Phase III trials and the overall survival of the patients who received best available therapy after ruxolotinib discontinuation, and this patient derived from the RUX-MF retrospective real-world study. To this aim, we created two models in order to adjust for different characteristics of the patient populations of the different studies, and also, we have performed a specific analysis concerning the patients with hemoglobin below 10 grams per deciliter.
In all of our analyses, we have consistently observed that momelotinib provides a greater overall survival benefit compared to BAT in patients with myelofibrosis previously treated with ruxolotinib. I believe that these findings really support the use of momelotinib as a standard of care in the patient with anemia who failed ruxolotinib therapy.
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Disclosures
Speakers Bureau: Novartis, BMS, AOP, Incyte, Telios, Sierra Oncology, Abbvie, Constellation-Morphosys, Sobi; Membership on an entity’s Board of Directors or advisory committees: Novartis, BMS, AOP, Incyte, Telios, Sierra Oncology, Abbvie, Constellation-Morphosys, Sobi.
