{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:09:49Z","timestamp":1792123789042,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,2,25]],"date-time":"2023-02-25T00:00:00Z","timestamp":1677283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,6]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In a pooled analysis of the phase 3 Controlled Myelofibrosis Study With Oral JAK Inhibitor Treatment I (COMFORT\u2010I) and COMFORT\u2010II clinical trials, adult patients with intermediate\u20102 or high\u2010risk myelofibrosis who received oral ruxolitinib at randomization or after crossover from placebo or best available therapy (BAT) had improved overall survival (OS).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This post hoc analysis of pooled COMFORT data examined relevant disease outcomes based on the disease duration (\u226412 or >12\u00a0months from diagnosis) before ruxolitinib initiation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The analysis included 525 patients (ruxolitinib: \u226412\u00a0months,\n n<\/jats:italic>\n \u00a0=\u00a084; >12\u00a0months,\n n<\/jats:italic>\n \u00a0=\u00a0216; placebo\/BAT: \u226412\u00a0months,\n n<\/jats:italic>\n \u00a0=\u00a066; >12\u00a0months,\n n<\/jats:italic>\n \u00a0=\u00a0159); the median age was 65.0\u201370.0\u00a0years. Fewer thrombocytopenia and anemia events were observed among patients who initiated ruxolitinib treatment earlier. At Weeks 24 and 48, the spleen volume response (SVR) was higher for patients who initiated ruxolitinib earlier (47.6% vs. 32.9% at Week 24,\n p<\/jats:italic>\n \u00a0=\u00a0.0610; 44.0% vs. 26.9% at Week 48,\n p<\/jats:italic>\n \u00a0=\u00a0.0149). In a multivariable analysis of factors associated with spleen volume reduction, a logistic regression model that controlled for confounding factors found that a significantly greater binary reduction was observed among patients with shorter versus longer disease duration (\n p<\/jats:italic>\n \u00a0=\u00a0.022). At Week 240, OS was significantly improved among patients who initiated ruxolitinib earlier (63% [95% CI, 51%\u201273%] vs. 57% [95% CI, 49%\u201264%]; hazard ratio, 1.53; 95% CI, 1.01\u20122.31;\n p<\/jats:italic>\n \u00a0=\u00a0.0430). Regardless of disease duration, a longer OS was observed for patients who received ruxolitinib versus those who received placebo\/BAT.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These findings suggest that earlier ruxolitinib initiation for adult patients with intermediate\u20102 and high\u2010risk myelofibrosis may improve clinical outcomes, including fewer cytopenia events, durable SVR, and prolonged OS.<\/jats:p>\n <\/jats:sec>\n \n Plain Language Summary<\/jats:title>\n \n \n \n Patients with myelofibrosis, a bone marrow cancer, often do not live as long as the general population. These patients may also have an enlarged spleen and difficult symptoms such as fatigue.<\/jats:p>\n <\/jats:list-item>\n \n Two large clinical trials showed that patients treated with the drug ruxolitinib lived longer and had improved symptoms compared to those treated with placebo or other standard treatments.<\/jats:p>\n <\/jats:list-item>\n \n Here it was examined whether starting treatment with ruxolitinib earlier (i.e., within a year of diagnosis) provided benefits versus delaying treatment.<\/jats:p>\n <\/jats:list-item>\n \n Patients who received ruxolitinib within a year of diagnosis lived longer and experienced fewer disease symptoms than those whose treatment was delayed.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cncr.34707","type":"journal-article","created":{"date-parts":[[2023,2,25]],"date-time":"2023-02-25T13:49:36Z","timestamp":1677332976000},"page":"1681-1690","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Early intervention in myelofibrosis and impact on outcomes: A pooled analysis of the COMFORT\u2010I and COMFORT\u2010II studies"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6912-8569","authenticated-orcid":false,"given":"Srdan","family":"Verstovsek","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Jacques","family":"Kiladjian","sequence":"additional","affiliation":[{"name":"H\u00f4pital Saint\u2010Louis Assistance Publique\u2013H\u00f4pitaux de Paris Universit\u00e9 Paris Cit\u00e9 INSERM Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro M.","family":"Vannucchi","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation of Myeloproliferative Neoplasms AOU Careggi University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5880-7972","authenticated-orcid":false,"given":"Ruben A.","family":"Mesa","sequence":"additional","affiliation":[{"name":"Mays Cancer Institute, UT Health San Antonio MD Anderson Cancer Center San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peg","family":"Squier","sequence":"additional","affiliation":[{"name":"Incyte Corporation Wilmington Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. E.","family":"Hamer\u2010Maansson","sequence":"additional","affiliation":[{"name":"Incyte Corporation Wilmington Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Harrison","sequence":"additional","affiliation":[{"name":"Guy\u2019s Hospital Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102016\u201003\u2010643544"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2012.42.1925"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.08.022"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102008\u201007\u2010170449"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201009\u2010245837"},{"key":"e_1_2_9_7_1","volume-title":"NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae) for Myeloproliferative Neoplasms, Version 1.2022","year":"2020"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26050"},{"key":"e_1_2_9_9_1","volume-title":"Full prescribing information","author":"JAKAFI\u00ae (ruxolitinib)","year":"2023"},{"key":"e_1_2_9_10_1","volume-title":"EU summary of product characteristics","author":"JAKAVI\u00ae (ruxolitinib)","year":"2023"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1110557"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1110556"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010017\u20100527\u20107"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102013\u201002\u2010485888"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2016.148"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010017\u20100417\u2010z"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.115840"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.143677"},{"key":"e_1_2_9_19_1","article-title":"Impact of bone marrow fibrosis grade on response and outcome in patients with primary myelofibrosis treated with ruxolitinib: a post\u2010hoc analysis of the JUMP study","author":"Palandri F","journal-title":"Paper presented at: EHA Congress 2021; 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