Alina Markova, MD, on the Future of Topical Ruxolitinib in Cutaneous Chronic GVHD and Multidisciplinary Implications

Alina Markova, MD, a dermatologist and director of inpatient consultative dermatology at Memorial Sloan Kettering Cancer Center, sat down with CancerNetwork® during the 2022 Tandem Meeting, to discuss future research efforts with topical ruxolitinib INCB018424 phosphate 1.5% cream (Opselura) for patients with non-sclerotic and superficially sclerotic chronic cutaneous graft-versus-host disease (GVHD), and multidisciplinary implications from a study assessing this treatment.

Markova highlighted how future efforts are needed to assess treatment in younger patients and adults to meet unmet needs and potentially lead to FDA approval. Additionally, she stated topical ruxolitinib could be used to taper patients off other systemic agents and avoid long-term treatment with topical corticosteroids.

Transcript:

We aim to conduct a multicenter prospective study where we can offer this as a frontline therapy in addition to systemic therapy for adults. We’d also love to enroll younger patients since we have many children with chronic [GVHD], where there’s an unmet need for topical therapies. Hopefully, one day [we will] even obtain an FDA indication for chronic cutaneous GVHD to be treated with topical ruxolitinib.

It can work in various ways. One way is for patients who have cutaneous-only chronic GVHD and are on systemic therapy, we can use the topical treatment to taper them off of systemic therapy and eventually only [receive] topical ruxolitinib and [then taper] off topical ruxolitinib. Also, for those patients who have partial response to oral ruxolitinib or to other systemic therapies that are dose limited by systemic toxicities or cytopenias, they can add topical ruxolitinib to get an improved overall response. In general, we can spare patients long-term topical corticosteroids [adverse] effects, such as skin thinning and bruising that are irreversible. We may also be able to use topical ruxolitinib in addition to topical steroids. They may both play a role in the topical treatment of chronic GVHD.

Reference

Markova A, Prockop SE, Dusza S, et al. Interim results of a pilot, prospective, randomized, double-blinded, vehicle-controlled trial on safety and efficacy of a topical inhibitor of Janus kinase 1/2 (ruxolitinib INCB018424 phosphate 1.5% cream) for non-sclerotic and superficially sclerotic chronic cutaneous graft-versus-host disease. Presented at: 2022 Transplantation & Cellular Therapy Meetings; Salt Lake City, UT; April 23-26, 2022. Abstract 390.