Encouraging Metabolic Profile Changes in Pacritinib-Treated Patients With MF

By Blood Cancers Today Staff Writers - Last Updated: December 20, 2024

A retrospective analysis of patients with myelofibrosis (MF) showed improvements in serum albumin levels without significant changes in weight or cholesterol during pacritinib treatment. The findings suggest a potential metabolic benefit of pacritinib, warranting further investigation in ongoing prospective studies.

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A low cachexia index score, indicated by low cholesterol and serum albumin levels of less than 4.3 g/dL, is associated with worse survival outcomes for patients with MF. Although ruxolitinib, as the standard-of-care treatment for MF, increases serum albumin levels and cholesterol, it can also cause weight gain, which could affect risk of cardiovascular disease. Francesca Palandri, MD, PhD, Università Di Bologna, Italy, and colleagues analyzed the metabolic profile changes during treatment with pacritinib, an alternative Janus kinase 2/interleukin receptor–associated kinase-1 inhibitor, in a retrospective study analyzing three clinical trials investigating pacritinib treatment (PERSIST-1 [NCT01773187], PERSIST-2 [NCT02055781], and PAC203 [NCT04884191]).1

Participants in the trials (n=484) were given either 200 mg or 400 mg of pacritinib once daily. Most participants (93%) had a normal or elevated body mass index. The investigators evaluated changes in cholesterol, weight, and serum albumin over 24-week periods.

Of 17 participants with baseline hypoalbuminemia levels less than 3.5 g/dL, 65% had improvements to normal levels at week 12, and 18% showed increases to greater than 4.3 g/dL. Among participants with albumin levels between 3.5 and 4.3 g/dL (n=210), 44% improved to greater than 4.3 g/dL, and 6% developed hypoalbuminemia. Finally, of 170 participants with albumin levels ≥4.3 g/dL, 85% maintained these levels.

Participants’ body weight remained stable over the 24 weeks of pacritinib therapy, regardless of baseline albumin levels. The cholesterol levels increased in 24% of participants with baseline levels less than 125 mg/dL, but none showed cholesterol increases greater than 200 mg/dL by week 24. Five of 26 participants receiving metformin and one of 15 receiving insulin could discontinue these medications during treatment.

Overall, pacritinib use in MF was associated with stable weight and relatively good metabolic function. Future prospective studies should seek to further understand these metabolic effects.

Reference

 

  1. Palandri F, Sobas M, Harrison C, et al. Improvement in serum albumin as a measure of improved metabolic profile in pacritinib-treated patients: a retrospective analysis of patients treated across three clinical trials. Abstract #3191. Presented at the American Society of Hematology Annual Meeting; December 7-10, 2024; San Diego, California.
Post Tags:ASH 2024: MF
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