Combo therapy for PV trial

[william-Indo]

Hi there,

Does anyone has treated with this combo Ruxolitinib and Interferon...?

Could you share your experince please..?

haematologica.org/article/v...

[WeeHarry]

HiI am on 5mg Rux twice daily no interferon so not able to comment on combination, Trust you will get info from others using both meds.

[EPguy]

I also have no 1st hand experience. But some observations:

In the report you included has a chart, attached below. The upper left graph has a notable feature. The allele drops off very quickly in the 1st couple months. INF is not known for such fast action, more for what the post 6 month slope looks like. (compare the *allele* vs HU for Ropeg in the Continuation PV study data below for such an INF-only shallower slope)

So in my opinion the Rux is having an effect here. This conveniently matches a new theory I had before seeing this- Start low dose Rux with a tolerable dose of INF to get a quick allele effect from Rux and start the long term INF benefits. Eventually cut the Rux if all is stable.

I note it says Rux has inflammation benefit. I'm all for that. But I'd guess once/if allele is reduced this may be less critical, so cutting Rux could be ok.

This trial was for those intolerant of INF. This part of the problem may benefit at least as much when Ropeg is available (this week in US if we're lucky). If so no need for Rux. But the quick allele effect intrigues me.

I have been planning to ask my Dr about this hybrid plan, he already proposed Rux to replace my HU.

All the above is only my opinion.

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mpn-hub.com/medical-informa...

Baseline * 37.3* 38.1 - -

Month 12 *24.4* 18.2 0.0244 6.646 (0.86 to 12.43)

Month 24 *14.3* 25.1 0.0003 –10.745 (–16.50 to –4.98)

Month 36 *11.3* 40.5 < 0.0001 –18.722 (–24.49 to –12.96)

Month 48 *9.2* 44.2 < 0.0001 –24.582 (–30.35 to –18.82)

Month 60 *8.5* 44.4 < 0.0001 –23.959 (–29.72 to –18.20)

============

INF+Rux

[william-Indo in reply to EPguy]

Thank you for your reply.

I have PV sinced 2019 and my HCT increasing to 50 and doctor give the full doses of 2000mg of HU for 3 mo.If not working, she suggest to change to Jakafi.

The combo Rux + INF give result 9% total remission,

I am consider to take this opportunity

[EPguy in reply to william-Indo]

That is a lot if HU, I think as high as we see in this forum.

I think the report defined remission as some level of resolution of all three of Blood counts, Allele and Symptom. It's not clear to me. If so that is a tough requirement.

I see the study was for 2 years. This is a limitation of many INF studies; it seems to offer continued improvements through at least 5 years.