Dr. Garcia on the Results of the REFINE Trial in Myelofibrosis

Jacqueline S. Garcia, MD, assistant professor of medicine, Harvard Medical School, physician, Dana-Farber Cancer Institute, discusses the results of the phase 2 REFINE trial (NCT03222609) in patients with myelofibrosis.

Patients eligible to participate in the REFINE trial had progression or suboptimal response to prior ruxolitinib (Jakafi) treatment, Garcia explains. In results published in the Journal of Clinical Oncology, 41% of patients who received the combination of the BCL-XL/BCL-2 inhibitor navitoclax and ruxolitinib experienced spleen volume reduction of at least 35% at any time on study. Moreover, bone marrow fibrosis improved by 1 or 2 grades in 33% of patients, and the median overall survival was not reached with a median follow-up of 21.6 months.

In terms of safety, although 88% of patients experienced thrombocytopenia in the trial, this adverse effect was temporary and mild. The drop in platelet levels was manageable with dose modification, Garcia concludes.