Conference Abstracts - 2025 Summit on Hematologic Cancers
Vol. 5, Issue Supplement 1, 2025 · S1-2
Bringing Trials to Clinics: Real-World Outcomes on Momelotinib and Pacritinib from a Multi-Center Cancer Network
Jeremy DiGennaro, DO,Sandra Jones, MD,Georgio Medawar, MD,Shiv Shah, MD,Rami Komrokji, MD,Alexander Coltoff, MD,Anthony Hunter, MD,Anand Patel, MD,Andrew Kuykendall, MD
Submission received: 2025-07-11 / Accepted: 2025-07-28 / Published: 2025-09-17
Abstract
Background
Pacritinib (PAC) and momelotinib (MMB) are JAK inhibitors that treat Myelofibrosis in patients suffering from thrombocytopenia and anemia, respectively. Both show the ability to improve spleen volume and disease-related symptoms.
Methods
149 patients were treated at four cancer institutes with either PAC or MMB. Treatment history and baseline hematologic characteristics were obtained. Hematologic values and transfusion requirements were assessed at 3-month intervals.
Results
At baseline, PAC-treated patients had median hemoglobin (hgb) and platelet (plt) counts of 8.7 g/dL (5.6-15.1 g/dL and 64 x 109/L (11-530 x 109/L), respectively. 37/66 (56%) had transfusion requirements averaging 1.2 RBC units/month. At 3, 6, 9, and 12 months, the median hgb values were 9.0 g/dL, 8.8 g/dL, 9.7 g/dL, and 10.0 g/dL. The median plt values at 3 month intervals were 75 x 109/L, 70 x 109/L, 64 x 109/L, 84 x 109/L, 76 x 109/L. At 3 and 12 months, the transfusion requirements decreased to 0.59 units/month and 0.33 units/month, respectively.
MMB-treated patients had baseline hgb and plt count of 8.6 g/dL (5.9-13.8 g/dL) and 186 x 109/L (14-889 x 109/L), respectively. 53/104 (51%) were transfusion-requiring with an average of 1.0 RBC units/month. At 3, 6, 9, and 12 months, the median hgb values were consistently at 9.2 g/dL. At 3 and 12 months, the transfusion requirements decreased to 0.40 units/month and 0.47 units/month, respectively. Hgb increase from baseline to 3 months was more marked in those patients who transitioned from ruxolitinib to MMB compared to patients with no ruxolitinib use at least 2 months prior to MMB (Δhgb 1.0 vs 0.2).
Median overall survival (mOS) was 15.2 months with PAC vs 16.8 months with MMB. Median duration of therapy was 4.9 months with PAC vs 10.3 months with MMB.
Conclusions
PAC and MMB have favorable hematologic profiles with statistically significant increases in baseline hemoglobin levels as well as decreased transfusion requirements. Despite similar mOS, there was a stark difference in median duration of treatment due to higher intolerance of pacritinib.