Addition of navitoclax to ongoing ruxolitinib for myelofibrosis patients with progression or suboptimal response

Targeting the BCL-X_Lpathway has demonstrate the ability to overcome Janus kinase inhibitor resistance in preclinical models. A multicenter phase II trial in the United States and the United Kingdom investigated the efficacy and safety or adding the BCL-X_L/BCL-2 inhibitor navitoclax to ongoing ruxolitinib therapy in myelofibrosis patients with progression or suboptimal response. Addition of navitoclax to ruxolitinib therapy resulted in durable ≥ 35% reduction of spleen volume, improved total symptom score, hemoglobin improvement, and improved bone marrow fibrosis.