My Treatment Approach: Optimizing Treatment for Chronic GVHD - Episode 5

Overview of Advanced Therapies in cGVHD

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Medical experts discuss advanced therapies in cGVHD.

Video content above is prompted by the following:

  • Dr Holtan:Both ruxolitinib and ibrutinib are approved for use in cases of cGVHD that have failed 1 or more lines of systemic therapy.

Briefly summarize and critique clinical trial data with ruxolitinib (REACH3) and ibrutinib (Miklos D, et al. Blood. 2017) in patients with cGVHD.

Comment on adverse effects most frequently seen with ruxolitinib and ibrutinib and how you manage them.

In which patients would you hesitate to use ruxolitinib or ibrutinib (eg, patients at risk of developing thrombocytopenia, etc)?

  • Belumosudil is approved for treatment of cGVHD after failure of 2 or more systemic therapies. Can you elaborate on anti-inflammatory and antifibrotic properties of belumosudil and results from preclinical and human studies in reduction of fibrosis (Flynn R, et al. Blood. 2016)?
    • How do these properties distinguish belumosudil from other targeted therapies for cGVHD?