Patients with myelofibrosis who were treated with the expected starting dose of ruxolitinib (Jakafi) demonstrated higher spleen response rates and a shorter median time to first response vs patients receiving a less-than-expected starting dose, per data from the ROMEI trial.
Additionally, overall survival (OS) was not reached in the as-expected group; however, patients in both groups reduced daily dosages over 12 months in the multicenter, observational, ongoing study, according to findings published in Cancer.
“To ensure optimal treatment with ruxolitinib, patients should be started on appropriate ruxolitinib doses and maintain the highest tolerated dose for maximum effectiveness,” wrote the study authors. “Patients who received the recommended doses showed a better trend in response.”
Trial Design and Key Data
The trial enrolled 508 adult ruxolitinib-naive patients who had been diagnosed with primary or secondary myelofibrosis across 51 centers in Italy between April 2017 and May 2022, at which time ruxolitinib was the only FDA-approved JAK inhibitor for myelofibrosis.
Patients with available baseline platelet counts were stratified into the as-expected (n = 174) and lower-than-expected (n = 132) dosage groups, resulting in 43% of patients receiving a lower-than-expected dose.
Changes in symptoms and health-related quality of life (HRQOL), assessed using Myeloproliferative Neoplasm 10 total symptom score (MPN-10 TSS) and EuroQol5-Dimension 5-Level (EQ-5D-5L), respectively, were primary end points of the study.