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EHA 2026 | Early versus delayed initiation of ropeginterferon alfa-2b in high-risk ET in the SURPASS-ET trial
Ruben Mesa, MD, Levine Cancer Institute, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC, discusses the two-year findings of the SURPASS-ET trial (NCT04285086), highlighting the impact of early versus delayed initiation of ropeginterferon alfa-2b in high-risk essential thrombocythemia (ET). Dr Mesa notes that the study’s findings suggest that earlier use of ropeginterferon may confer benefits and have a deeper impact on long-term outcomes, supporting its use earlier in the disease course. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
The SURPASS-ET study was a randomized phase III study of ropeginterferon alpha-2b versus anagrelide in the second-line setting for patients with essential thrombocythemia. And we had previously shown the top-line data demonstrating the ability of ropeginterferon superior to anagrelide for better control of the platelet count, a further impact on the molecular response in the disease, favorability in terms of thromboembolic events...
The SURPASS-ET study was a randomized phase III study of ropeginterferon alpha-2b versus anagrelide in the second-line setting for patients with essential thrombocythemia. And we had previously shown the top-line data demonstrating the ability of ropeginterferon superior to anagrelide for better control of the platelet count, a further impact on the molecular response in the disease, favorability in terms of thromboembolic events. It was a very positive phase III study. What my colleague, Dr Gill, presents at this year’s EHA meeting is kind of the next step. So this was a randomized trial through year one, and then in year two, patients that had been on the anagrelide arm were then allowed to cross over onto the ropeginterferon arm, which really gave us really an additional set of information. Patients that started on ropeginterferon from kind of the enrollment in the study versus those that really started after a year of anagrelide first. And what that demonstrates was really superior outcomes. First, in terms of ability to control the platelet count and other aspects of the disease. But second, that there was a clear favorability in terms of the molecular response. You know, we hope that patients that cross over later will eventually achieve molecular response, but at best that is delayed and certainly is kind of diminished in comparison. So I view that, you know, but these data continues to tell us that ropeginterferon is both more effective in that kind of short-term lens of efficacy, platelet count control, tolerability, lack of thrombohemorrhagic events, but also that there is this aspect of better molecular control that we feel will probably have a deeper impact for the longer term. And hopefully, again, as we follow these patients out longer and longer, we’ll show less progression to myelofibrosis or other secondary aspects, which very much would match what we have seen in polycythemia vera, where the use of ropeginterferon earlier in the course of the disease probably makes a difference in terms of that progression free survival.
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