NCCN guidance on ropeginterferon alfa-2b in MPN

Ongoing supply challenges with peginterferon alfa‑2a have highlighted the practical importance of alternative interferon options within the National Comprehensive Cancer Network (NCCN) guidelines for myeloproliferative neoplasms (MPN).¹ Ropeginterferon alfa‑2b is a long‑acting, monopegylated interferon with a prolonged half-life, enabling administration every 2 weeks with the potential for monthly maintenance.^2,3 It has been included in the NCCN guidelines for polycythemia vera (PV) since 2022, where it is listed as a preferred cytoreductive therapy option for symptomatic low-risk patients requiring treatment and for those with high-risk disease. This positioning is supported by phase III data from the PROUD‑PV study and its extension, CONTINUATION‑PV, which demonstrated sustained hematologic and molecular responses, alongside improved event-free survival, over long-term follow-up.⁴  

The latest NCCN guidance also recognizes ropeginterferon alfa‑2b as an appropriate alternative in PV, myelofibrosis, and essential thrombocythemia when peginterferon alfa‑2a is unavailable.¹ Strategies for transitioning between the two interferons are largely based on clinical experience, with careful monitoring of response and tolerability advised.⁵ 

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