Momelotinib in JAKi-naïve MF: Real-world findings

Results from a retrospective study evaluating momelotinib therapy in 60 patients with Janus kinase inhibitor (JAKi)-naïve myelofibrosis (MF) were recently published in the American Journal of Hematology by Tefferi et al. The study was conducted to assess efficacy and toxicity of momelotinib outside of a clinical trial setting post-U.S. Food and Drug Administration (FDA) approval.

Key data: Median follow-up time was 10.5 months (range, 1–23). An anemia response occurred in 23% of patients (transfusion-dependent anemia [TDA] in 15% and non-TDA in 30%; p = 0.15) with a median time to anemia response of 3 months. Predictors of anemia response included circulating blasts <2%, presence of SH2B3 mutation, and elevated interleukin-2 (IL-2) soluble. The most common treatment-emergent adverse events (TEAEs) were >20% decrease in estimated glomerular filtration rate (29%), Grade 3/4 thrombocytopenia (28%), and gastrointestinal symptoms (27%). Symptoms of peripheral neuropathy were reported by 20% of patients with complete or partial recovery documented in 33% and 25% of patients, respectively.

Key learning: In this study, anemia response rates to momelotinib were similar to those reported in other recent real-world studies in patients with MF. Risk factors for common TEAEs, including peripheral neuropathy, should be considered to optimize individualized JAKi selection.