Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Taussig Cancer Institute and Cleveland Clinic, Cleveland, OH
Manmeet Singh Ahluwalia , Yasmeen Rauf , Glen Stevens , David M. Peereboom
Background: Ruxolitinib is a novel, selective inhibitor of JAK1 (Janus kinase 1) and JAK2 and JAK3. JAK signaling involves recruitment of signal transducers and activators of transcription (STATs) to cytokine receptors, activation, and subsequent localization of STATs to the nucleus leading to modulation of gene expression. Dysregulation of the JAK/STAT pathway has been associated with several types of cancer and increased proliferation and survival of malignant cells. Preclinical evidence supports inhibition of JAJK STAT pathway arrogated glioma growth. Methods: Ruxolitinib is a novel, selective inhibitor of JAK1 (Janus kinase 1) and JAK2 and JAK3. JAK signaling involves recruitment of signal transducers and activators of transcription (STATs) to cytokine receptors, activation, and subsequent localization of STATs to the nucleus leading to modulation of gene expression. Dysregulation of the JAK/STAT pathway has been associated with several types of cancer and increased proliferation and survival of malignant cells. Preclinical evidence supports inhibition of JAJK STAT pathway arrogated glioma growth. Results: 60 patients were treated on the study and there were no dose limiting toxicity seen on the protocol. Survival data was calculated for GBM. The OS for arm 1 was 18.17 (10.15, NA) and was not reached for arm 2. The 1 year OS was 0.62 for arm 1 and 0.93 for arm 2. Patients that received ruxolitinib + radiation x 60 Gy + daily temozolomide at 75 mg/m2 for 6 weeks over 6 weeks (Arm 2) had significantly better PFS and OS than those that received ruxolitinib + radiation x 60 Gy alone. Conclusions: Dose of 20 mg twice daily of ruxolitinib is safe with radiation and temozolomide. Preliminary survival data appears promising compared to the historical benchmarks and randomized phase 2 trial is planned. Clinical trial information: NCT03514069.
Total N | Number of Deaths | Median OS in Month (95%CI) | Rate at 1 Year (95%CI) | P-value | ||
---|---|---|---|---|---|---|
All patients | 37 | 11 | NA ( 18.17, NA ) | 0.75 ( 0.61, 0.91 ) | ||
Arm | Arm 1 | 22 | 10 | 18.17 ( 10.15, NA ) | 0.62 ( 0.44, 0.87 ) | 0.015 |
Arm 2 | 15 | 1 | NA ( NA, NA ) | 0.93 ( 0.82, 1 ) | ||
Gender | F | 16 | 4 | NA ( 15.93, NA ) | 0.8 ( 0.62, 1 ) | 0.554 |
M | 21 | 7 | NA ( 18.17, NA ) | 0.71 ( 0.54, 0.94 ) |
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Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Manmeet Singh Ahluwalia
2021 ASCO Annual Meeting
First Author: Yasmeen Rauf
2023 ASCO Annual Meeting
First Author: Dinu Stefan
2021 ASCO Annual Meeting
First Author: Katherine B. Peters