Optimizing management of ruxolitinib in patients with myelofibrosis: the need for individualized dosing

Ruxolitinib, an oral JAK1 and JAK2 inhibitor, is approved in the US for patients with intermediate or high-risk myelofibrosis (MF), a chronic neoplasm associated with aberrant myeloproliferation, progressive bone marrow fibrosis, splenomegaly, and burdensome symptoms. Phase III clinical studies have...

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Bibliographic Details
Published in:Journal of hematology and oncology 2013-10, Vol.6 (1), p.79-79, Article 79
Main Authors: Mesa, Ruben A, Cortes, Jorge
Format: Article
Language:English
Subjects:
Abdomen
Anemia
Anemia - chemically induced
Anemia - drug therapy
Blood
Blood platelets
Cancer
Colleges & universities
Comparative analysis
Complications and side effects
Drug dosages
Drug therapy
Genetic aspects
Hematology
Humans
Leukemia
Medical research
Medical treatment
Medicine, Experimental
Myelofibrosis
Nitriles
Oncology
Pain
Patients
Precision Medicine
Primary Myelofibrosis - drug therapy
Primary Myelofibrosis - pathology
Pyrazoles - administration & dosage
Pyrazoles - adverse effects
Pyrimidines
Review
Spleen
Thrombocytopenia - chemically induced
Thrombocytopenia - drug therapy
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Summary:Ruxolitinib, an oral JAK1 and JAK2 inhibitor, is approved in the US for patients with intermediate or high-risk myelofibrosis (MF), a chronic neoplasm associated with aberrant myeloproliferation, progressive bone marrow fibrosis, splenomegaly, and burdensome symptoms. Phase III clinical studies have shown that ruxolitinib reduces splenomegaly and alleviates MF-related symptoms, with concomitant improvements in quality of life measures, for the overwhelming majority of treated patients. In addition, ruxolitinib provided an overall survival advantage as compared with either placebo or what was previously considered best available therapy in the two phase III studies. The most common adverse events with ruxolitinib treatment include dose-dependent anemia and thrombocytopenia, which are expected based on its mechanism of action. Experience from the phase III studies shows that these hematologic events can be managed effectively with dose modifications, temporary treatment interruptions, as well as red blood cell transfusions in the case of anemia and, importantly, are rarely cause for permanent treatment discontinuation. This review summarizes data supporting appropriate individualized patient management through careful monitoring of blood counts and dose titration as needed in order to maximize treatment benefit.
ISSN:1756-8722
1756-8722
DOI:10.1186/1756-8722-6-79