Ruxolitinib for the treatment of BOS after allo-HSCT

Results of a multicenter study, evaluating ruxolitinib (n = 77) vs non-ruxolitinib therapies (n = 48) for the second-line treatment of patients with bronchiolitis obliterans syndrome (BOS) post-allogeneic hematopoietic stem cell transplantation (allo-HSCT), were published in Annals of Hematology  by Tu et al. The primary endpoint was progression of BOS at Month 3 after initiation of second-line therapy.

Key data: By Month 3, 18.2% of patients treated with ruxolitinib had progressive disease (PD) vs 43.8% of those treated with non-ruxolitinib therapies (control; p = 0.001). The 2-year overall survival (OS) was 73.2% vs 60.2% in the ruxolitinib and control groups, respectively (p = 0.012). BOS-progression-free survival (BOS-PFS) was 69% vs 51.2%, respectively (p = 0.011). Overall incidence of adverse events (AEs) was 42.9% in the ruxolitinib group vs 54.2% in the control group.

Key learning: Preliminary evidence suggests ruxolitinib is an effective and well tolerated second-line treatment option for BOS. With the development of novel agents and strategies in recent years, the optimal management of pulmonary chronic graft-versus-host disease (cGvHD) has yet to be defined through large-scale real-world studies.