Dr. Garcia on Research With the Combination of Navitoclax/Ruxolitinib in Myelofibrosis

Jacqueline S. Garcia, MD, instructor in Medicine, Department of Medical Oncology, Harvard Medical School, and physician, Dana-Farber Cancer Institute, discusses research with the combination of navitoclax and ruxolitinib (Jakafi) in patients with myelofibrosis.

Investigators evaluated the efficacy and safety of navitoclax in combination with ruxolitinib in patients with primary myelofibrosis (n = 16), post-essential thrombocythemia myelofibrosis (n = 5), and post-polycythemia vera myelofibrosis (n = 13).

Patients had to have received ≥12 weeks of ruxolitinib prior to enrolling on the phase II trial. Among 34 treated patients, the median treatment duration was 330 days, suggesting that the combination is well tolerated, says Garcia. Responses were reported across all investigational dose levels, including 100 mg, 200 mg, and 300 mg. Moreover, 68% of patients reached the maximum tolerated dose of navitoclax at 300 mg daily.

In terms of clinical benefit, 30% of patients (n = 10) achieved a spleen volume reduction of ≥35%, says Garcia; this included the majority of patients with high-risk molecular mutations. Among the entire population, 17 of 33 patients harbored ≥1 high-risk mutation, concludes Garcia.