A new JAK inhibitor drug may help reduce the risk of graft versus host disease in half-matched stem cell transplants, according to a new study.
A phase I trial of the investigational drug, itacitinib, has had unexpectedly promising results, according to researchers at the Washington University School of Medicine, St Louis, USA.
42 patients took part in the trial, receiving the drug before haploidentical transplantation and up to six months afterwards. The patients were being treated for a range of blood cancers.
The researchers report that no patients developed severe graft versus host disease in the six months after their transplant.
After one year, 89% of the patients remained free of chronic GvH disease. Two patients had developed moderate or severe chronic disease by that time.
As a JAK inhibitor, the drug is designed to block enzymes that contribute to inflammation.
Study leader Professor John DiPersio said: “We have to be cautious about interpreting the results of a small study, but the rates of graft-versus-host disease were unexpectedly low. We saw no severe GvHD, and the rates of relapse were lower than expected in these high-risk patients. Low GvHD rates and low relapse resulted in very encouraging survival for the patients in this study.
“These early results are compelling, and we hope to conduct a bigger randomised controlled clinical trial to be able to evaluate efficacy.”
Fellow researcher Dr Ramzi Abboud, said: “We are interested in investigating these drugs as a possible way to prevent graft-versus-host disease by giving them before the transplant. We suspect that JAK inhibitors will have a place in prevention of this life-threatening side effect of stem cell transplants.
“This study is encouraging, and we expect to know more about how best to use these prevention strategies in the coming years.”
Source:
Abboud R, Schroeder MA, Rettig MP, Jayasinghe RG, Gao F, Eisele J, Gehrs L, Ritchey JK, Choi J, Abboud CN, Pusic I, Jacoby MA, Westervelt P, Christopher M, Cashen AF, Ghobadi A, Stockerl-Goldstein K, Uy GL, DiPersio JF. (2024) “Itacitinib for prevention of graft-versus-host disease and cytokine release syndrome with T cell replete peripheral blood haploidentical transplantation.” Blood, 22 November 2024, doi: 10.1182/blood.2024026497
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