Combined ruxolitinib and pegasys therapy for MF and PV gives great results. Danish phase 2 study Jan 2020 ( ruxopeg)

[Rachelthepotter]

Hi

I’ve pasted in the abstract of the Danish ruxopeg study instead of just the link, as it’s such an important result. The combination of ruxolitinib and pegasys does look to be worth trying.

Ruxolitinib And Interferon-Α2 Combination Therapy For Patients With Polycythemia Vera Or Myelofibrosis: A Phase II Study.

Anders Lindholm Sørensen, Stine Ulrik Mikkelsen, Trine Alma Knudsen, Mads Emil Bjørn, Christen Lykkegaard Andersen, Ole Weis Bjerrum, Nana Brochmann, Dustin Andersen Patel, Lise Mette Rahbek Gjerdrum, Daniel El Fassi, Torben A. Kruse, Thomas Stauffer Larsen, Hans Torben Mourits-Andersen, Claus Henrik Nielsen, Christina Ellervik, Niels Pallisgaard, Mads Thomassen, Lasse Kjær, Vibe Skov, Hans Carl Hasselbalch

Haematologica January 2020 : haematol.2019.235648; Doi:10.3324/haematol.2019

Abstract

We report the final two-year end-of-study results from the first clinical trial investigating combination treatment with ruxolitinib and low-dose pegylated interferon-α2 (PEG-IFNα2). The study included 32 patients with polycythemia vera (PV) and 18 with primary- or secondary myelofibrosis (MF); 46 patients were previously intolerant or refractory to PEG-IFNα2.

The primary outcome was efficacy, based on hematological parameters, quality of life measurements, and JAK2 V617F allele burden.

We used the 2013 ELN and IWG-MRT response criteria, including response in symptoms, splenomegaly, peripheral blood counts, and bone marrow. Of 32 patients with PV, 10 (31%) achieved remission; 3 (9%) achieved complete remission. Of 18 patients with MF, 8 (44%) achieved remission; 5 (28%) achieved complete remission. The cumulative incidence of peripheral blood count remission was 0.85 and 0.75 for patients with PV and MF, respectively. MPN-SAF total symptom score decreased from 22 (95%CI, 16-29) at baseline to 15 (95%CI, 10-22) after two years. The median JAK2 V617F allele burden de-creased from 47% (95%CI, 33-61%) to 12% (95%CI, 6-22%), and 41% of patients achieved a molecular response. The drop-out was 6% for PV patients and 32% for MF patients. Of 36 patients previously in-tolerant to PEG-IFNα2, 31 (86%) completed the study, and 24 (67%) of these received PEG-IFNα2 throughout the study. In conclusion, combination treatment improved cell counts, reduced bone marrow cellularity and fibrosis, decreased JAK2 V617F burden, and reduced symptom burden with acceptable toxicity in several patients with polycythemia vera or myelofibrosis. #EudraCT2013-003295-12.

· Received August 18, 2019.

· Accepted December 20, 2019.

· Copyright © 2020, Ferrata Storti Foundation

[Aneliv9]

I think i have post it to! Just that when they mention complete remission to MF, they don't mean exactly perfect remission as we understand it. They have some specific key points. But it remains significant step

[Rachelthepotter in reply to Aneliv9]

Hi Aneliv - Apologies if I implied that I’d been the first, or only person to find this study - other people have pointed it out too.

Remission doesn’t mean a return to perfect health , but this is the first study to actually show that the bone fibrosis can be reversed. And people felt a whole lot better.

What cheers me is that pegasys and rux have both now been around for a while, and have had a chance to show their side effects. Unlike some of the new Jak inhibitors.

[Aneliv9 in reply to Rachelthepotter]

I didn't mean that you can't post the same! I wrote it just with enthusiasm!And maybe i am wrong and complete remission means total MF reversal. I will read it again more carefully.

[Rachelthepotter in reply to Aneliv9]

So glad we are both enthusiastic about sharing good research!

[Paul123456]

How did you get on yesterday? Did they manage to get a good sample?

Best Paul

[Bluetop]

Thanks for this! some very positive results.

[LucyAshtonGeering]

Thanks so much for this - am just awaiting confirmation of a diagnosis of secondary MF and am going to beg for treatment so I’ll take a printout of this. I was dx with ET JAK2+ 2 &1/2 years ago at 37yo, and have been on Watch & Wait and aspirin only. My quality of life is poor and as my MPN has progressed, I’m determined to get something to help me with this. So thanks again 🤞🏽

[Lab-Rat in reply to LucyAshtonGeering]

Hi Lucy, so sorry to read your ET is now MF. I too had an initial diagnosis of ET Jak2+ which after 2 years was reclassified (following a BMB) as grade 1 early MF proliferative stage. I am on Ruxolitinib (Jakavi/Jakafi) 20 mg/day (too many side effects at > 20 mg), magic bullet for bone pain and increased quality of life. I’m re-starting combo treatment with Pegasys 90 mcg/month as my platelets are creeping back up. I’ve been on this combo before and the Jakavi really reduces the aches and pains and flu-like symptoms I get from Pegasys alone. I do hope Jakavi will be offered to you. I work full time at a demanding job including international travel (obviously no travel now due to Covid) thanks to my treatment regime. Waiting for confirmation of diagnosis is stressful, please let us know once you get confirmation and what your treatment plan will be. Best wishes.

[LucyAshtonGeering in reply to Lab-Rat]

Thank you so much for your kind and empathetic message. And for your description of your experience with MF meds, which I'll arm myself with when I see / speak to my drs. It sounds like you're in good hands with your illness and treatment, that is great. I'm wondering what age you are; I've just turned 40 and would really like treatment so I can return to work (post-lockdown). My appointment is in a fortnight, so I'm comforting myself with the thought that this must mean it's not AML at least, otherwise they'd have summoned me back in straightaway. MPNs run in my family and I'm feeling so bored of it all at the moment - it'll be good to know the results and receive some treatment!