ROP-ET: a prospective phase III trial investigating the efficacy and safety of ropeginterferon alfa-2b in essential thrombocythemia patients with limited treatment options.
Disease modification
Essential thrombocythemia (ET)
Myeloproliferative neoplasms (MPNs)
Phase III
ROP-ET
Ropeginterferon alfa-2b
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
04 Mar 2024
04 Mar 2024
Historique:
received:
12
01
2024
accepted:
15
02
2024
medline:
5
3
2024
pubmed:
5
3
2024
entrez:
4
3
2024
Statut:
aheadofprint
Résumé
Interferon-based therapies, such as ropeginterferon alfa-2b have emerged as promising disease-modifying agents for myeloproliferative neoplasms (MPNs), including essential thrombocythemia (ET). Current ET treatments aim to normalize hematological parameters and reduce the thrombotic risk, but they do not modify the natural history of the disease and hence, have no impact on disease progression. Ropeginterferon alfa-2b (trade name BESREMi®), a novel, monopegylated interferon alfa-2b with an extended administration interval, has demonstrated a robust and sustained efficacy in polycythemia vera (PV) patients. Given the similarities in disease pathophysiology and treatment goals, ropeginterferon alfa-2b holds promise as a treatment option for ET. The ROP-ET trial is a prospective, multicenter, single-arm phase III study that includes patients with ET who are intolerant or resistant to, and/or are ineligible for current therapies, such as hydroxyurea (HU), anagrelide (ANA), busulfan (BUS) and pipobroman, leaving these patients with limited treatment options. The primary endpoint is a composite response of hematologic parameters and disease-related symptoms, according to modified European LeukemiaNet (ELN) criteria. Secondary endpoints include improvements in symptoms and quality of life, molecular response and the safety profile of ropeginterferon alfa-2b. Over a 3-year period the trial assesses longer term outcomes, particularly the effects on allele burden and clinical outcomes, such as disease-related symptoms, vascular events and disease progression. No prospective clinical trial data exist for ropeginterferon alfa-2b in the planned ET study population and this study will provide new findings that may contribute to advancing the treatment landscape for ET patients with limited alternatives. TRIAL REGISTRATION: EU Clinical Trials Register; EudraCT, 2023-505160-12-00; Registered on October 30, 2023.
Identifiants
pubmed: 38438627
doi: 10.1007/s00277-024-05665-4
pii: 10.1007/s00277-024-05665-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Kiladjian JJ, Cassinat B, Chevret S et al (2008) Pegylated interferon-alfa-2a induces complete hematologic and molecular responses with low toxicity in polycythemia vera. Blood 112(8):3065–3072. https://doi.org/10.1182/blood-2008-03-143537
doi: 10.1182/blood-2008-03-143537
pubmed: 18650451
Masarova L, Patel KP, Newberry KJ et al (2017) Pegylated interferon alfa-2a in patients with essential thrombocythaemia or polycythaemia vera: a post-hoc, median 83 month follow-up of an open-label, phase 2 trial. Lancet Haematol 4(4):e165–e175. https://doi.org/10.1016/S2352-3026(17)30030-3
doi: 10.1016/S2352-3026(17)30030-3
pubmed: 28291640
pmcid: 5421384
Knudsen TA, Hansen DL, Ocias LF et al (2018) Long-term efficacy and safety of recombinant interferon alpha-2 vs. hydroxyurea in polycythemia vera: preliminary results from the three-year analysis of the Daliah Trial - a randomized controlled phase III clinical trial. Blood 132(no Suppl 1):pp580. https://doi.org/10.1182/blood-2018-99-111255
doi: 10.1182/blood-2018-99-111255
Yacoub A, Mascarenhas J, Kosiorek H et al (2019) Pegylated interferon alfa-2a for polycythemia vera or essential thrombocythemia resistant or intolerant to hydroxyurea. Blood 134(18):1498–1509. https://doi.org/10.1182/blood.2019000428
doi: 10.1182/blood.2019000428
pubmed: 31515250
pmcid: 6839950
Gisslinger H, Klade C, Georgiev P et al (2020) Ropeginterferon alfa-2b versus standard therapy for polycythaemia vera (PROUD-PV and CONTINUATION-PV): a randomised, non-inferiority, phase 3 trial and its extension study. Lancet Haematol 7(3):e196–e208. https://doi.org/10.1016/S2352-3026(19)30236-4
doi: 10.1016/S2352-3026(19)30236-4
pubmed: 32014125
Mascarenhas J, Kosiorek HE, Prchal JT et al (2022) A randomized phase 3 trial of interferon-alpha vs hydroxyurea in polycythemia vera and essential thrombocythemia. Blood 139(19):2931–2941. https://doi.org/10.1182/blood.2021012743
doi: 10.1182/blood.2021012743
pubmed: 35007321
pmcid: 9101248
Barbui T, Vannucchi AM, De Stefano V et al (2023) Ropeginterferon versus standard therapy for low-risk patients with polycythemia vera. NEJM Evid 2(6). https://doi.org/10.1056/EVIDoa2200335
Gisslinger H, Klade C, Georgiev P et al (2023) Event-free survival in patients with polycythemia vera treated with ropeginterferon alfa-2b versus best available treatment. Leukemia. https://doi.org/10.1038/s41375-023-02008-6
doi: 10.1038/s41375-023-02008-6
pubmed: 37634011
pmcid: 10539163
Kiladjian JJ, Klade C, Georgiev P et al (2022) Long-term outcomes of polycythemia vera patients treated with ropeginterferon Alfa-2b. Leukemia 36(5):1408–1411. https://doi.org/10.1038/s41375-022-01528-x
doi: 10.1038/s41375-022-01528-x
pubmed: 35210530
pmcid: 9061291
Hasselbalch HC, Holmstrom MO (2019) Perspectives on interferon-alpha in the treatment of polycythemia vera and related myeloproliferative neoplasms: minimal residual disease and cure? Semin Immunopathol 41(1):5–19. https://doi.org/10.1007/s00281-018-0700-2
doi: 10.1007/s00281-018-0700-2
pubmed: 30203226
Abu-Zeinah G, Silver RT, Abu-Zeinah K et al (2021) Normal life expectancy for polycythemia vera (PV) patients is possible. Leukemia 36(2):569–572. https://doi.org/10.1038/s41375-021-01447-3
doi: 10.1038/s41375-021-01447-3
pubmed: 34625712
How J, Garcia JS, Mullally A (2023) Biology and therapeutic targeting of molecular mechanisms in MPNs. Blood 141(16):1922–1933. https://doi.org/10.1182/blood.2022017416
doi: 10.1182/blood.2022017416
pubmed: 36534936
Verger E, Soret-Dulphy J, Maslah N et al (2018) Ropeginterferon alpha-2b targets JAK2V617F-positive polycythemia vera cells in vitro and in vivo. Blood Cancer J 8(10):94. https://doi.org/10.1038/s41408-018-0133-0
doi: 10.1038/s41408-018-0133-0
pubmed: 30287855
pmcid: 6172224
How J, Hobbs G (2022) Interferons as the first choice of cytoreduction in essential thrombocythemia and polycythemia vera. J Natl Compr Canc Netw 20(9):1063–1068. https://doi.org/10.6004/jnccn.2022.7026
doi: 10.6004/jnccn.2022.7026
pubmed: 36075385
Godfrey AL, Green AC, Harrison CN (2023) Essential thrombocythemia: challenges in clinical practice and future prospects. Blood 141(16):1943–1953. https://doi.org/10.1182/blood.2022017625
doi: 10.1182/blood.2022017625
pubmed: 36379024
Masarova L, Verstovsek S (2019) Emerging drugs for essential thrombocythemia. Expert Opin Emerg Drugs 24(2):93–105. https://doi.org/10.1080/14728214.2019.1615437
doi: 10.1080/14728214.2019.1615437
pubmed: 31050912
Birgegard G, Besses C, Griesshammer M et al (2018) Treatment of essential thrombocythemia in Europe: a prospective long-term observational study of 3649 high-risk patients in the evaluation of anagrelide efficacy and long-term safety study. Haematologica 103(1):51–60. https://doi.org/10.3324/haematol.2017.174672
doi: 10.3324/haematol.2017.174672
pubmed: 29079600
pmcid: 5777190
Gisslinger H, Gotic M, Holowiecki J et al (2013) Anagrelide compared with hydroxyurea in WHO-classified essential thrombocythemia: the ANAHYDRET Study, a randomized controlled trial. Blood 121(10):1720–1728. https://doi.org/10.1182/blood-2012-07-443770
doi: 10.1182/blood-2012-07-443770
pubmed: 23315161
pmcid: 3591796
Tefferi A, Vannucchi AM, Barbui T (2018) Essential thrombocythemia treatment algorithm 2018. Blood Cancer J 8(1):2. https://doi.org/10.1038/s41408-017-0041-8
doi: 10.1038/s41408-017-0041-8
pubmed: 29321520
pmcid: 5802626
Alvarez-Larran A, Martinez-Aviles L, Hernandez-Boluda JC et al (2014) Busulfan in patients with polycythemia vera or essential thrombocythemia refractory or intolerant to hydroxyurea. Ann Hematol 93(12):2037–2043. https://doi.org/10.1007/s00277-014-2152-7
doi: 10.1007/s00277-014-2152-7
pubmed: 24981691
Hernandez-Boluda JC, Alvarez-Larran A, Gomez M et al (2011) Clinical evaluation of the European LeukaemiaNet criteria for clinicohaematological response and resistance/intolerance to hydroxycarbamide in essential thrombocythaemia. Br J Haematol 152(1):81–88. https://doi.org/10.1111/j.1365-2141.2010.08430.x
doi: 10.1111/j.1365-2141.2010.08430.x
pubmed: 21083657
Birgegard G (2016) The use of anagrelide in myeloproliferative neoplasms, with focus on essential thrombocythemia. Curr Hematol Malig Rep 11(5):348–355. https://doi.org/10.1007/s11899-016-0335-0
doi: 10.1007/s11899-016-0335-0
pubmed: 27497846
pmcid: 5031713
Arber DA, Orazi A, Hasserjian R et al (2016) The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 127(20):2391–2405. https://doi.org/10.1182/blood-2016-03-643544
doi: 10.1182/blood-2016-03-643544
pubmed: 27069254
Barosi G, Besses C, Birgegard G et al (2007) A unified definition of clinical resistance/intolerance to hydroxyurea in essential thrombocythemia: results of a consensus process by an international working group. Leukemia 21(2):277–280. https://doi.org/10.1038/sj.leu.2404473
doi: 10.1038/sj.leu.2404473
pubmed: 17251900
Barosi G, Mesa R, Finazzi G et al (2013) Revised response criteria for polycythemia vera and essential thrombocythemia: an ELN and IWG-MRT consensus project. Blood 121(23):4778–4781. https://doi.org/10.1182/blood-2013-01-478891
doi: 10.1182/blood-2013-01-478891
pubmed: 23591792
pmcid: 3674675
Stegelmann F, Teichmann LL, Heidel FH et al (2023) Clinicohematologic and molecular response of essential thrombocythemia patients treated with pegylated interferon-alpha: a multi-center study of the German Study Group-Myeloproliferative Neoplasms (GSG-MPN). Leukemia 37(4):924–928. https://doi.org/10.1038/s41375-023-01837-9
doi: 10.1038/s41375-023-01837-9
pubmed: 36828867
pmcid: 10079540
ICH Harmonised Tripartite Guideline (1999) Statistical principles for clinical trials, international conference on harmonisation E9 Expert Working Group Stat Med 18(15):1905–1942. https://www.ncbi.nlm.nih.gov/pubmed/10532877
Gilreath JA, Tashi T, Kim SJ et al (2018) Compassionate use of ropeginterferon-alfa-2b/P1101 for treatment of high risk polycythemia vera and essential thrombocythemia patients previously controlled on pegylated interferon-alfa-2a/Pegasys®. Blood 132(Supplement 1):5459–5459. https://doi.org/10.1182/blood-2018-99-116852
doi: 10.1182/blood-2018-99-116852
How J, Hobbs G (2022) Real-world experience of ropeginterferon in myeloproliferative neoplasm patients. Blood 140(Supplement 1):12284–12285. https://doi.org/10.1182/blood-2022-157076
doi: 10.1182/blood-2022-157076
Huang CE, Wu YY, Hsu CC et al (2021) Real-world experience with ropeginterferon-alpha 2b (Besremi) in philadelphia-negative myeloproliferative neoplasms. J Formos Med Assoc 120(2):863–873. https://doi.org/10.1016/j.jfma.2020.08.021
doi: 10.1016/j.jfma.2020.08.021
pubmed: 32873465
Novak W, Annamária C, Crazzolara R et al (2022) Severe complications in JAK2 V617F positive pediatric patients with myeloproliferative neoplasms. Hemasphere 6(Suppl):936–937. https://doi.org/10.1097/01.HS9.0000852292.38263.b8
doi: 10.1097/01.HS9.0000852292.38263.b8
pmcid: 9429437
Okikiolu J, Woodley C, Cadman-Davies L et al (2023) Real world experience with ropeginterferon alpha-2b (Besremi) in essential thrombocythaemia and polycythaemia vera following exposure to pegylated interferon alfa-2a (Pegasys). Leuk Res Rep 19:100360. https://doi.org/10.1016/j.lrr.2022.100360
doi: 10.1016/j.lrr.2022.100360
pubmed: 36590864
Podstavková N, Weinbergerová B, Procházková J et al (2022) Current experience with ropeginterferon Alfa-2b in Ph negative myeloproliferative neoplasm at the Department of Internal Medicine – Haematology and Oncology in Brno. Transfuze Hematol Dnes 28(4):1–6. https://doi.org/10.48095/cctahd2022prolekare.cz15
doi: 10.48095/cctahd2022prolekare.cz15
Tashi T, Reeves BN, Kim SJ et al (2023) Real-world experience of ropeginterferon-alfa treatment of PV and ET - Two centers experience. Blood 142(Supplement 1):6397. https://doi.org/10.1182/blood-2023-191268
doi: 10.1182/blood-2023-191268
Barbui T, Tefferi A, Vannucchi AM et al (2018) Philadelphia chromosome-negative classical myeloproliferative neoplasms: revised management recommendations from European LeukemiaNet. Leukemia 32(5):1057–1069. https://doi.org/10.1038/s41375-018-0077-1
doi: 10.1038/s41375-018-0077-1
pubmed: 29515238
pmcid: 5986069
Alvarez-Larran A, Sant’Antonio E, Harrison C et al (2021) Unmet clinical needs in the management of CALR-mutated essential thrombocythaemia: a consensus-based proposal from the European LeukemiaNet. Lancet Haematol 8(9):e658–e665. https://doi.org/10.1016/S2352-3026(21)00204-0
doi: 10.1016/S2352-3026(21)00204-0
pubmed: 34450103
Mesa RA, Jamieson C, Bhatia R et al (2017) NCCN guidelines insights: Myeloproliferative neoplasms, version 2.2018. J Natl Compr Canc Netw 15(10):1193–1207. https://doi.org/10.6004/jnccn.2017.0157
doi: 10.6004/jnccn.2017.0157
pubmed: 28982745
Bewersdorf JP, Giri S, Wang R et al (2021) Interferon alpha therapy in essential thrombocythemia and polycythemia vera-a systematic review and meta-analysis. Leukemia 35(6):1643–1660. https://doi.org/10.1038/s41375-020-01020-4
doi: 10.1038/s41375-020-01020-4
pubmed: 32868875
Gu W, Yang R, Xiao Z et al (2021) Clinical outcomes of interferon therapy for polycythemia vera and essential thrombocythemia: a systematic review and meta-analysis. Int J Hematol 114(3):342–354. https://doi.org/10.1007/s12185-021-03171-1
doi: 10.1007/s12185-021-03171-1
pubmed: 34091876
Beauverd Y, Ianotto J-C, Thaw KH et al (2023) Impact of cytoreductive drugs upon outcomes in a contemporary cohort of adolescent and young adults with essential thrombocythemia and polycythemia vera. Retrieved from https://ash.confex.com/ash/2023/webprogram/Paper185108.html . Accessed 27 Nov 2023
Alvarado Y, Cortes J, Verstovsek S et al (2003) Pilot study of pegylated interferon-alpha 2b in patients with essential thrombocythemia. Cancer Chemother Pharmacol 51(1):81–86. https://doi.org/10.1007/s00280-002-0533-4
doi: 10.1007/s00280-002-0533-4
pubmed: 12497210
Langer C, Lengfelder E, Thiele J et al (2005) Pegylated interferon for the treatment of high risk essential thrombocythemia: results of a phase II study. Haematologica 90(10):1333–1338
pubmed: 16219569
Verger E, Cassinat B, Chauveau A et al (2015) Clinical and molecular response to interferon-alpha therapy in essential thrombocythemia patients with CALR mutations. Blood 126(24):2585–2591. https://doi.org/10.1182/blood-2015-07-659060
doi: 10.1182/blood-2015-07-659060
pubmed: 26486786
Gowin K, Thapaliya P, Samuelson J et al (2012) Experience with pegylated interferon alpha-2a in advanced myeloproliferative neoplasms in an international cohort of 118 patients. Haematologica 97(10):1570–1573. https://doi.org/10.3324/haematol.2011.061390
doi: 10.3324/haematol.2011.061390
pubmed: 22419578
pmcid: 3487558
Gowin K, Jain T, Kosiorek H et al (2017) Pegylated interferon alpha – 2a is clinically effective and tolerable in myeloproliferative neoplasm patients treated off clinical trial. Leuk Res 54:73–77. https://doi.org/10.1016/j.leukres.2017.01.006
doi: 10.1016/j.leukres.2017.01.006
pubmed: 28113109
Jabbour E, Kantarjian H, Cortes J et al (2007) PEG-IFN-alpha-2b therapy in BCR-ABL-negative myeloproliferative disorders: final result of a phase 2 study. Cancer 110(9):2012–2018. https://doi.org/10.1002/cncr.23018
doi: 10.1002/cncr.23018
pubmed: 17849460
Samuelsson J, Hasselbalch H, Bruserud O et al (2006) A phase II trial of pegylated interferon alpha-2b therapy for polycythemia vera and essential thrombocythemia: feasibility, clinical and biologic effects, and impact on quality of life. Cancer 106(11):2397–2405. https://doi.org/10.1002/cncr.21900
doi: 10.1002/cncr.21900
pubmed: 16639737
Verstovsek S, Komatsu N, Gill H et al (2022) SURPASS-ET: phase III study of ropeginterferon alfa-2b versus anagrelide as second-line therapy in essential thrombocythemia. Future Oncol 18(27):2999–3009. https://doi.org/10.2217/fon-2022-0596
doi: 10.2217/fon-2022-0596
pubmed: 35924546
Masarova L, Mascarenhas J, Qin A et al (2023) EXCEED-ET: a single-arm multicenter study to assess the efficacy, safety, and tolerability of ropeginterferon alfa-2b-njft (P1101) in north American adults with essential thrombocythemia. J Clin Oncol 41(16):TPS7088–TPS7088. https://doi.org/10.1200/JCO.2023.41.16_suppl.TPS7088
doi: 10.1200/JCO.2023.41.16_suppl.TPS7088
Gisslinger H, Zagrijtschuk O, Buxhofer-Ausch V et al (2015) Ropeginterferon alfa-2b, a novel IFNalpha-2b, induces high response rates with low toxicity in patients with polycythemia vera. Blood 126(15):1762–1769. https://doi.org/10.1182/blood-2015-04-637280
doi: 10.1182/blood-2015-04-637280
pubmed: 26261238
pmcid: 4608390
Edahiro Y, Ohishi K, Gotoh A et al (2022) Efficacy and safety of ropeginterferon alfa-2b in Japanese patients with polycythemia vera: an open-label, single-arm, phase 2 study. Int J Hematol 116(2):215–227. https://doi.org/10.1007/s12185-022-03341-9
doi: 10.1007/s12185-022-03341-9
pubmed: 35430707
Ferrer-Marin F, Arroyo AB, Bellosillo B et al (2020) miR-146a rs2431697 identifies myeloproliferative neoplasm patients with higher secondary myelofibrosis progression risk. Leukemia 34(10):2648–2659. https://doi.org/10.1038/s41375-020-0767-3
doi: 10.1038/s41375-020-0767-3
pubmed: 32107471
Hasselbalch HC, Bjorn ME (2015) MPNs as inflammatory diseases: the evidence, consequences, and perspectives. Mediators Inflamm 2015:102476. https://doi.org/10.1155/2015/102476
doi: 10.1155/2015/102476
pubmed: 26604428
pmcid: 4641200
Morales ML, Ferrer-Marin F (2023) Deepening our understanding of the factors affecting landscape of myeloproliferative neoplasms: what do we know about them? Cancers (Basel) 15(4). https://doi.org/10.3390/cancers15041348
Guy A, Favre S, Labrouche-Colomer S et al (2019) High circulating levels of MPO-DNA are associated with thrombosis in patients with MPN. Leukemia 33(10):2544–2548. https://doi.org/10.1038/s41375-019-0500-2
doi: 10.1038/s41375-019-0500-2
pubmed: 31175322
Schmidt S, Daniliants D, Hiller E et al (2021) Increased levels of NETosis in myeloproliferative neoplasms are not linked to thrombotic events. Blood Adv 5(18):3515–3527. https://doi.org/10.1182/bloodadvances.2020004061
doi: 10.1182/bloodadvances.2020004061
pubmed: 34464975
pmcid: 8945589
Ferrer-Marin F, Cuenca-Zamora EJ, Guijarro-Carrillo PJ et al (2021) Emerging role of neutrophils in the thrombosis of chronic myeloproliferative neoplasms. Int J Mol Sci 22(3). https://doi.org/10.3390/ijms22031143
Marin Oyarzun CP, Carestia A, Lev PR et al (2016) Neutrophil extracellular trap formation and circulating nucleosomes in patients with chronic myeloproliferative neoplasms. Sci Rep 6:38738. https://doi.org/10.1038/srep38738
doi: 10.1038/srep38738
pubmed: 27958278
pmcid: 5153854
Wolach O, Sellar RS, Martinod K et al (2018) Increased neutrophil extracellular trap formation promotes thrombosis in myeloproliferative neoplasms. Sci Transl Med 10(436). https://doi.org/10.1126/scitranslmed.aan8292