A 10-year retrospective cohort study of ruxolitinib and association with nonmelanoma skin cancer in patients with polycythemia vera and myelofibrosis

Clinical trials report occurrence of nonmelanoma skin cancers (NMSCs) with ruxolitinib in patients with polycythemia vera (PV) or myelofibrosis (MF); however, the level of risk and effect of covariates are not known in the real-world setting. To systematically assess the risk of developing NMSC afte...

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Published in:Journal of the American Academy of Dermatology 2022-02, Vol.86 (2), p.339-344
Main Authors: Lin, John Q., Li, Shirley Q., Li, Shufeng, Kiamanesh, Eileen F., Aasi, Sumaira Z., Kwong, Bernice Y., Su Chang, Anne Lynn
Format: Article
Language:English
Subjects:
basal cell carcinoma
Cohort Studies
Humans
JAK1
JAK2
myelofibrosis
Nitriles
nonmelanoma skin cancer
polycythemia vera
Polycythemia Vera - complications
Polycythemia Vera - drug therapy
Primary Myelofibrosis - drug therapy
Pyrazoles
Pyrimidines
Retrospective Studies
ruxolitinib
Skin Neoplasms - epidemiology
squamous cell carcinoma
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Summary:Clinical trials report occurrence of nonmelanoma skin cancers (NMSCs) with ruxolitinib in patients with polycythemia vera (PV) or myelofibrosis (MF); however, the level of risk and effect of covariates are not known in the real-world setting. To systematically assess the risk of developing NMSC after ruxolitinib exposure in patients with PV or MF. A 10-year retrospective cohort of patients with PV or MF at Stanford Medical Center was identified and matched according to age, gender, race, Charlson Comorbidity Index, disease diagnosis, and follow-up time. The main outcome measure was hazard ratio (HR) for NMSC (comprised of basal cell carcinoma and squamous cell carcinoma [SCC]) after ruxolitinib exposure, adjusted for covariates. The study cohort consisted of 564 patients (188 exposed to ruxolitinib for at least 4 weeks, 376 unexposed). Ruxolitinib-exposed patients with PV or MF had an adjusted NMSC HR of 2.69 (95% CI, 1.03-7.02). In particular, ruxolitinib exposure was associated with SCC (HR, 3.24; 95% CI, 1.45-7.22), with non–Janus kinase 2-mutated patients showing even higher SCC risk (HR, 7.40; 95% CI, 2.54-21.63). Retrospective design. Our real-world results indicate that SCC risk is increased in patients with PV or MF taking ruxolitinib and support consideration of skin cancer monitoring.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2021.10.004