Ruxolitinib for the treatment of patients with steroid-refractory GVHD: an introduction to the REACH trials

For patients with hematologic malignancies and disorders, allogeneic hematopoietic stem cell transplantation offers a potentially curative treatment option. Many patients develop graft-versus-host disease (GVHD), a serious complication and leading cause of nonrelapse mortality. Corticosteroids are t...

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Bibliographic Details
Published inImmunotherapy Vol. 10; no. 5; pp. 391 - 402
Main Authors Jagasia, Madan, Zeiser, Robert, Arbushites, Michael, Delaite, Patricia, Gadbaw, Brian, Bubnoff, Nikolas von
Format Journal Article
LanguageEnglish
Published England Future Medicine Ltd 01.04.2018
Subjects
Adrenal Cortex Hormones
allogeneic stem cell transplant
Bone marrow
Chronic illnesses
Clinical trials
Clinical Trials, Phase II as Topic
Clinical Trials, Phase III as Topic
Corticosteroids
Cytokines
FDA approval
Graft vs Host Disease - drug therapy
Graft-versus-host reaction
Hematopoietic stem cells
Humans
JAK
Janus kinase
Janus kinase 2
Leukemia
Lymphocytes
Mortality
Multicenter Studies as Topic
Nitriles
Patients
Prospective Studies
Pyrazoles - therapeutic use
Pyrimidines
refractory graft-versus-host disease
Stem cell transplantation
Stem cells
Targeted cancer therapy
Transplants & implants
Treatment Outcome
refractory graft-versus-host disease
JAK
allogeneic stem cell transplant
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Summary:For patients with hematologic malignancies and disorders, allogeneic hematopoietic stem cell transplantation offers a potentially curative treatment option. Many patients develop graft-versus-host disease (GVHD), a serious complication and leading cause of nonrelapse mortality. Corticosteroids are the standard first-line treatment for GVHD; however, patients often become steroid-refractory or remain corticosteroid-dependent. New second-line treatment options are needed to improve patient outcomes. Here we review the role of JAK1 and JAK2 in acute and chronic GVHD. We also describe the study designs of the Phase II REACH1 (NCT02953678) and the Phase III REACH2 (NCT02913261) and REACH3 (NCT03112603) clinical trials that are currently recruiting patients to evaluate the JAK1/JAK2 inhibitor ruxolitinib in patients with corticosteroid-refractory acute or chronic GVHD.
ISSN:1750-743X
1750-7448
DOI:10.2217/imt-2017-0156