Dr Kremyanskaya on the Promise of Rusfertide in Phlebotomy-Dependent PV

Marina Kremyanskaya, MD, PhD, assistant professor, medicine, hematology, and medical oncology, Icahn School of Medicine, Mount Sinai, medical director, Inpatient Oncology Unit, The Mount Sinai Hospital, discusses the potential advantages of using rusfertide (PTG-300) to treat patients with phlebotomy-dependent polycythemia vera (PV), as seen in the phase 2 REVIVE trial (NCT04057040).

At the 2023 EHA Congress, investigators presented data from the phase 2 open-label, dose-escalation REVIVE trial. The potential advantage that rusfertide offers to patients with PV is that it could eliminate phlebotomy requirements for patients who are heavily dependent on phlebotomies, Kremyanskaya begins. In particular, rusfertide could make a difference in the treatment of patients who do not tolerate phlebotomies well, and in those who are symptomatic from the multiple phlebotomies they are undergoing, she explains. Notably, Kremyanskaya believes that an additional benefit is that rusfertide can be and is often given as an additional agent to the PV-directed therapy that a patient is already on.

Often, the dose of a cytoreductive agent, such as an interferon or hydroxyurea, cannot be increased because patients cannot tolerate the higher dose. However, these patients still require phlebotomies and may still besymptomatic, Kremyanskaya expands. Therefore, the use of rusfertide given as an additional agent to the PV-directed therapy that a patient is already receiving may be effective, she emphasizes. Accordingly, in the future, rusfertide may be an additional agent for patients who derive some benefit from cytoreductive therapy but do not completely respond to this therapy, as well as for patients who do not tolerate phlebotomies well, Kremyanskaya notes.

Treatment with rusfertide could free these patients from being dependent on frequent follow-up visits to an institution and worrying about their blood counts, and in turn lead to significant improvements in their levels of independence and in their quality of life, Kremyanskaya concludes.