Momelotinib Versus Danazol in-Previously Treated Thrombocytopenic Myelofibrosis

According to a presentation at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, momelotinib was superior to danazol for symptom response, transfusion requirement, spleen response, and survival, with comparable safety, for patients with thrombocytopenic myelofibrosis patients who were symptomatic and anemic.

The study, led by Aaron Thomas Gerds, included 81 patients treated with momelotinib and 43 patients treated with danazol. The primary endpoint of the study was the Total Symptom Score (TSS) response at week 24, while additional endpoints included red blood cell transfusion independence (TI) rates and changes from baseline in TSS, splenic response rates (SRR), and absence of transfusions.

According to the researchers, the median baseline TSS was 29 for the momelotinib group and 24 for the danazol group; hemoglobin was 7.9 g/dL for momelotinib and 8.0 g/dL for danazol; and platelet counts were 67 × 109/L for momelotinib and 64 × 109/L for danazol. Previous JAK inhibitor treatments included ruxolitinib in 124 patients and fedratinib in six patients. The authors noted that these results were comparable with a cohort of 195 intention-to-treat patients. Notably, a trend toward improved overall survival was seen in the momelotinib group versus the danazol group up to week 24 (hazard ratio = 0.490; 95% confidence interval, 0.195–1.235). Treatment effects were similar in analyses of baseline platelet count subgroups.

In short, the authors suggested that momelotinib “may address a critical unmet need” in patients with thrombocytopenic MF.