Objective:

To retrospectively compare long-term treatment outcomes in patients with myelofibrosis treated with momelotinib, ruxolitinib, fedratinib, and BMS-911543, identify specific clinical and molecular predictors of response and survival, and examine the impact of treatment response on survival.

Key Findings:

• Momelotinib showed a higher anemia response (54%) compared to ruxolitinib (45.2%) and fedratinib (43%), indicating its potential advantage in managing anemia.
• Patients on momelotinib remained on therapy longer (median 21 months) than those on ruxolitinib (10 months), suggesting better treatment adherence.
• Discontinuation rates at 3 and 5 years were 77% and 92%, respectively, with suboptimal response or progressive disease as the main reasons, highlighting the challenges in long-term treatment.

Interpretation:

The study highlights the differential effects of JAK2 inhibitors on anemia and treatment duration, suggesting momelotinib may offer advantages in managing anemia in myelofibrosis patients, which could influence treatment choices.

Limitations:

• Retrospective design may introduce bias, potentially affecting the reliability of the findings.
• Limited generalizability due to specific patient population and clinical trial settings, which may not reflect broader patient demographics.

Conclusion:

Momelotinib may provide better management of anemia and longer treatment duration compared to other JAK2 inhibitors, warranting further investigation into its long-term survival benefits to validate these findings.