This recent report points to benefits of combining Rux and IFN. Of particular interest is the low doses that were enabled toward the end.
-Notable: "The JAK2V617F allele burden was significantly reduced 3 months after the start of treatment, and continued to decline from a median of 47% to 6%."
In the plot here from this report I've added the Ropeg (Besremi) results. Not necessarily comparable across different studies, including this one used PEG, but interesting. Even assuming the median start at 47%, combo got to 6% while Ropeg alone is 14% at 2 years. Shifting the combo to the lower baseline used in Ropeg, the end result is 2%. From the slopes it looks that the combo works faster than IFN alone. Hoping this study goes for longer for better comparisons.
Further, at just 24 months, 4pts (17%) were at <1% allele. Ropeg had 19% there at 5 years.
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In this recent thread, getting allele reduced is looking ever more important.
healthunlocked.com/mpnvoice...
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Low doses: at follow up, doses were just 45mcg/2weeks PEG and 5 BID(twice a day) for Rux. Rux pills go from 5-25, 5 being lowest possible dose. This contrasts vs Ropeg trial which used near the highest published doses for the study.
The main adverse event was anemia "Grade 1-2 anemia was frequent and managed with dose reductions." We're all for dose reductions. Seems high grade events were reduced but not clearly presented.
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I've posted before that IFN seems to lose some allele benefit after 5 years, on average, including hidden data from the Ropeg trial. Maybe this approach could help?
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Bottom line, powerful allele reductions at low doses in this small combo study.
This study is ongoing and they promise more/other data soon. For those doing well on either this may not be relevant. But for the many with adverse events on either, so far: "Combination therapy with the two agents may be more efficacious than monotherapy." Mr Dr is agreeable to this concept. But insurance coverage could be a problem.
ashpublications.org/blood/a...
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