Safety and efficacy of jaktinib (a novel JAK inhibitor) in patients with myelofibrosis who are intolerant to ruxolitinib: A single‐arm, open‐label, phase 2, multicenter study

Author:

Zhang Yi1234ORCID,Zhou Hu5,Duan Minghui6ORCID,Gao Sujun7,He Guangsheng8ORCID,Jing Hongmei9,Li Junmin10,Ma Liangming11,Zhu Huanling12ORCID,Chang Chunkang13,Du Xin14,Hong Mei15ORCID,Li Xin16,Liu Qingchi17,Wang Wei18,Xu Na19,Yang Haiping20,Lu Binhua21,Yin Hewen21,Wu Liqing21,Suo Shanshan1234,Zhao Qingwei22,Xiao Zhijian23ORCID,Jin Jie1234ORCID

Affiliation:

1. Department of Hematology, the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou People's Republic of China

2. Zhejiang Provincial Key Laboratory of Hematopoietic Malignancy Zhejiang University Hangzhou Zhejiang People's Republic of China

3. Zhejiang Provincial Clinical Research Center for Hematological disorders Hangzhou People's Republic of China

4. Zhejiang University Cancer Center Hangzhou People's Republic of China

5. Department of Hematology The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital Zhengzhou People's Republic of China

6. Department of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College Peking Union Medical College Hospital Beijing People's Republic of China

7. Department of Hematology The First Hospital of Jilin University Changchun People's Republic of China

8. Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital Key Laboratory of Hematology of Nanjing Medical University, Collaborative Innovation Center for Cancer Personalize Jiangsu People's Republic of China

9. Department of Hematology Peking University Third Hospital Beijing People's Republic of China

10. Department of Hematology, Ruijin Hospital Shanghai Jiaotong University Medical School Shanghai People's Republic of China

11. Department of Hematology, Shanxi Bethune Hospital The Third Hospital of Shanxi Medical University Taiyuan People's Republic of China

12. Department of Hematology, West China Hospital Sichuan University Chengdu People's Republic of China

13. Department of Hematology Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai People's Republic of China

14. Department of Hematology, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou People's Republic of China

15. Department of Hematology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan People's Republic of China

16. Department of Hematology, The Third Xiangya Hospital Central South University Changsha People's Republic of China

17. Department of Hematology The First Hospital of Hebei Medical University Shijiazhuang People's Republic of China

18. Department of Hematology The Affiliated Hospital of Qingdao University Qingdao People's Republic of China

19. Department of Hematology, Nanfang Hospital Southern Medical University Guangzhou People's Republic of China

20. Department of Hematology The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology Luoyang People's Republic of China

21. Suzhou Zelgen Biopharmaceuticals Co, Ltd Suzhou People's Republic of China

22. Department of Clinical pharmacy the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou People's Republic of China

23. Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin People's Republic of China

Abstract

AbstractAlthough ruxolitinib improves splenomegaly and constitutional symptoms in patients with myelofibrosis (MF), a substantial proportion of patients discontinue ruxolitinib because of intolerance. This phase 2 trial investigated the safety and efficacy of jaktinib, a novel JAK inhibitor in patients with ruxolitinib‐intolerant MF. The primary endpoint was the proportion of patients with ≥35% reduction in spleen volume (SVR35) at week 24. The secondary endpoints included change of MF‐related symptoms, anemic response, and safety profiles. Between December 18, 2019, and November 24, 2021, 51 patients were enrolled, 45 treated with jaktinib 100 mg bid (100 mg bid group) and six received non‐100 mg bid doses (non‐100 mg bid group). The SVR35 at week 24 in the 100 mg bid group was 43.2% (19/44, 95% CI 29.7%–57.8%). There were 41.9% (13/31) of transfusion‐independent patients with hemoglobin (HGB) ≤100 g/L who had HGB elevation ≥20 g/L within 24 weeks. The proportion of patients with a ≥50% decrease in the total symptom score (TSS 50) at week 24 was 61.8% (21/34). The most commonly reported grade ≥3 treatment‐emergent adverse events (TEAEs) in the 100 mg bid group were anemia 31.1%, thrombocytopenia 22.2%, and infectious pneumonia 17.8%. A total of 16 (35.6%) in the 100 mg bid group had serious adverse events, and 4 (8.9%) were considered possibly drug related. These results indicate jaktinib can provide a treatment option for patients with MF who are intolerant to ruxolitinib.

Funder

National Natural Science Foundation of China

Publisher

Wiley

Subject

Hematology

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