Interferon-Alpha Reduces Myelofibrosis Risk, Mortality Rate in Low- and High-Risk Polycythemia Vera

[Manouche]

“In an intent-to-treat analysis, IFN was associated with improved OS in high-risk PV, with a 20-year OS probability of 66% in the IFN group, 40% in the HU group, and 14% in the phlebotomy-only group.

The rate of myelofibrosis-free survival (MFS) of high-risk patients was similarly higher in patients treated with IFN, with a 20-year probability of 89%, compared with the HU group (41%) and the phlebotomy-only group (36%)...

The rate of Myelofibrosis Free Survival of low-risk patients was significantly higher in those treated with IFN (84%) than in the HU (65%) and phlebotomy (55%) groups”

onclive.com/view/interferon...

[MPort]

Thank you for posting this. So if we do a comparison with your post of the other study it looks like:Ropeginterferon reduces allele burden much better so a high percentage of patients on it can go into remission and need no treatment. Therefore no develment into MF.

In the study above normal interferon (Pegasys?) slows down development into MF for patients with higher allele burden (84%) and for patients with low allele burden (89%).

I have to write this out to try to understand the significance of these studies.

But the bottom line is there is a lot more hope.

Thank you so much for posting these reports.

[Manouche in reply to MPort]

Hi Mport,

Higher risk patients are those over 60 with an history of thrombosis. The allele burden is not considered as a clinical factor in this study. There is still no evidence that ropeginterferon is clinically better than peginterferon or non-pegylated interferon. We just know that pegylated IFN are less toxic and better tolerated, which is a huge improvement as such.

[Aldebaran25]

Hi Manouche, thanks for posting this. I clicked on the link but it does not take me to the study mentioned . Still, very very encouraging how much evidence is building up in favour of IFN . When the time comes I hope to be able to tolerate it :). Hope you spent a pleasant Xmas. thanks again

[Manouche in reply to Aldebaran25]

Oops sorry about the link. This is the correct one:

onclive.com/view/interferon...

Best wishes

[Aldebaran25 in reply to Manouche]

that works! thanks

[Manouche in reply to Aldebaran25]

FYI:

« the MPN scientific community still recommends patients with low risk disease to be observed without any cytoreductive treatment. Using this “watch and wait” strategy translation of common knowledge on cancer biology to MPNs is neglected, implying progression of any cancer without treatment. Early treatment with IFN has been claimed to be a prerequisite for obtaining remarkable results to prohibit clonal evolution before subclones and additive mutations evolve. »

onlinelibrary.wiley.com/doi...

[Meatloaf9 in reply to Manouche]

Thank you for posting this. Based on this article, everyone with ET and PV should be started on interferons at the time of diagnosis. In their study it contributes to an increased survival, CHR, with lowering of the allele burden and clinical remissions in many patients though not all. I don't know why hematologists are not pushing for interferons to replace HU as the first line of treatment. If the information in this article is correct the watch and weight treatment is out of date as all that does is watch the disease progress. There is no way to do controlled studies that take 10 years at least not morally when it takes that long just to obtain the that type of data. Just my opinion, be well.

[EmeraldA]

Hi, thank you so much for posting. I have thought about this before but I wonder with all the new findings regarding interferon I wonder if all people diagnosed with ET or PV will be put on interferon when diagnosed. Is there enough data and evidence for this to now be part of the MPN treatment protocol? Last time this question was asked at one of the forums it was said that there was not enough evidence of this. Is there enough evidence now? I would hate to find out in a number of years that my / our ET / MPN and its progression could have been better managed and maybe have better outcomes in terms of slowing / reducing MF risk if it was used. Just wonder what others views are on this? Also I know that interferon is not without side effects tolerance etc. Thanks and happy holidays everyone! B

[Manouche in reply to EmeraldA]

Not all patients will be put on interferon. In term of cost/efficiency, Hydrea is superior to Pegasys for patients over 65.

[Meatloaf9 in reply to Manouche]

Hi and thanks again for this article and for your information. Do you know or have a link to any articles that report that HU is better than interferon for patients over 65 in preventing or slowing progression to MF or AML for ET or PV patients? Thanks again.

[Manouche in reply to Meatloaf9]

Hi Meatloaf, I’m not aware of any study reporting better outcomes with HU compared to Pegasys for patients over 65. In term of cost-effectiveness , HU is superior. In other words, HU seems to have a higher value for money than Pegasys which is quite a cynical but important factor in decision making for many haemotologists.

[Meatloaf9 in reply to Manouche]

Thanks for the reply. I think it is sad that we have a potentially disease altering medication that might prevent progression of the disease and it is not utilized due to cost. I guess that's just life. The retail price of Pegasys in the US is around 6000 per mo.