Ruxolitinib + ECP for steroid-refractory GvHD

Results from a single-center retrospective study comparing ruxolitinib (Rux) + extracorporeal photopheresis (ECP) (n = 31) vs Rux alone (n = 37) in patients with steroid-refractory (SR) acute graft-versus-host disease (aGvHD) and chronic graft-versus-host disease (cGvHD) were recently published in the Journal of Clinical Medicine Research by Halahleh et al. The primary objective was to compare the overall response rate (ORR) at last encounter between treatment arms. Key secondary endpoints included incidence of progression from aGvHD to cGvHD, 1-year non-relapse mortality (NRM), GvHD relapse-free survival (GRFS), and survival outcomes.

Key data: The ORR at last encounter was 58% for Rux + ECP vs 49% for Rux alone (p = 0.002). There was no significant difference in progression to cGvHD between treatment groups (74% [95% confidence interval [CI], 55–87%] vs 59% [95% CI, 41–76%] for Rux + ECP and Rux alone, respectively [p = 0.387]). No significant difference in 1-year NRM (19% vs 0%; p = 0.31), 3-year survival (70% vs 80%; p = 0.36), or 3-year GRFS (94.7% vs 100%; p = 0.23) was observed between Rux + ECP vs Rux alone.

Key learning: Combining Rux with ECP may improve long-term control of SR-aGvHD and cGvHD compared with Rux alone, supporting the potential benefit of dual immunomodulatory approaches in this setting.