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莫洛替尼在曾使用过Janus激酶抑制剂的亚洲骨髓纤维化合并贫血患者中的疗效与安全性。

Efficacy and safety of momelotinib in Janus kinase inhibitor-experienced Asian patients with myelofibrosis and anemia.

作者信息

Yoon Sung-Soo, Chen Chih Cheng, Lee Sung-Eun, Chang Hung, Cheong June-Won, Hou Hsin-An, Lee Won Sik, Lim Sung-Nam, Moon Joon Ho, Ong Kiat Hoe, Dai Yi, Liu Chang, Kawashima Jun, Goh Yeow Tee

机构信息

Division of Hematology/Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Department of Internal Medicine - Division of Hematology and Oncology Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Puzi City, Taiwan.

出版信息

Int J Hematol. 2025 Jul 21. doi: 10.1007/s12185-025-04037-6.

Abstract

INTRODUCTION

This post hoc analysis investigated the efficacy and safety of momelotinib in the Asian subpopulation of MOMENTUM (NCT04173494).

METHODS

Patients were randomized 2:1 to momelotinib 200 mg once daily (QD) plus danazol placebo (momelotinib group) or danazol 600 mg QD plus momelotinib placebo (danazol group) for 24 weeks (W), after which they could receive open-label momelotinib or danazol.

PRIMARY ENDPOINT

W24 total symptom score (TSS) response rate (≥ 50% reduction from baseline). W24 key secondary endpoints: transfusion independence rate; mean TSS change from baseline; splenic response rate; rate of zero transfusions.

RESULTS

Seventeen Asian patients with myelofibrosis were included (momelotinib: n = 11; danazol: n = 6). TSS response rate at W24 was 36.4% with momelotinib and 0% with danazol. Secondary endpoints favored momelotinib and were consistent with the intention-to-treat population. Grade ≥ 3 treatment-emergent adverse events were reported in 36.4 and 66.7% of the momelotinib and danazol groups, respectively, including one grade ≥ 3 anemia in the momelotinib group. Treatment interruption and/or dose reduction occurred in 18.2 and 16.7% of the momelotinib and danazol groups, respectively. Two danazol-treated patients discontinued study treatment.

CONCLUSION

In the Asian subpopulation of MOMENTUM, momelotinib improved myelofibrosis-associated symptoms, anemia measures, and spleen response, with generally favorable safety versus danazol.

摘要

引言

本事后分析研究了莫美替尼在MOMENTUM研究(NCT04173494)亚洲亚组中的疗效和安全性。

方法

患者按2:1随机分组,分别接受每日一次200毫克莫美替尼加达那唑安慰剂(莫美替尼组)或每日一次600毫克达那唑加莫美替尼安慰剂(达那唑组)治疗24周,之后他们可以接受开放标签的莫美替尼或达那唑治疗。

主要终点

第24周时总症状评分(TSS)缓解率(较基线降低≥50%)。第24周时关键次要终点:输血独立率;TSS较基线的平均变化;脾脏缓解率;零输血率。

结果

纳入了17例亚洲骨髓纤维化患者(莫美替尼组:n = 11;达那唑组:n = 6)。第24周时,莫美替尼组的TSS缓解率为36.4%,达那唑组为0%。次要终点支持莫美替尼,且与意向性治疗人群一致。莫美替尼组和达那唑组分别有36.4%和66.7%的患者报告了≥3级治疗中出现的不良事件,莫美替尼组包括1例≥3级贫血。莫美替尼组和达那唑组分别有18.2%和16.7%的患者出现治疗中断和/或剂量减少。2例接受达那唑治疗的患者停止了研究治疗。

结论

在MOMENTUM研究的亚洲亚组中,莫美替尼改善了骨髓纤维化相关症状、贫血指标和脾脏反应,与达那唑相比,安全性总体良好。

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