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iwMPN 2026 | Symptom endpoints in myelofibrosis trials: superiority versus non-inferiority against ruxolitinib
Ruben Mesa, MD, Levine Cancer Institute, Winston-Salem, NC, discusses whether head-to-head trials should assess novel agents and combination therapies for myelofibrosis as superior or noninferior to ruxolitinib for symptom improvement. Dr Mesa explains that, in the frontline setting, ruxolitinib substantially improves symptoms by 24 weeks, making superiority difficult to achieve and positioning non-inferiority as a more appropriate goal. However, in the second-line setting, superiority in symptom improvement remains achievable. This interview took place at the 4th International Workshop on Myelodysplastic Syndromes & Myeloproliferative Neoplasms (iwMDS/iwMPN) 2026, held in Washington, D.C.
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