A 10-year retrospective cohort study of ruxolitinib and association with non-melanoma skin cancer in polycythemia vera and myelofibrosis patients. Journal of the American Academy of Dermatology Lin, J. Q., Li, S. Q., Li, S., Kiamanesh, E. F., Aasi, S. Z., Kwong, B. Y., Chang, A. L. 2021


BACKGROUND: Clinical trials report occurrence of non-melanoma skin cancers (NMSC) with ruxolitinib in polycythemia (PV) or myelofibrosis (MF) patients, however the level of risk and effect of covariates are not known in the real-world setting.OBJECTIVE: To systematically assess the risk of developing non-melanoma skin cancer (NMSC) after ruxolitinib exposure in PV or MF patients.METHODS: A 10-year retrospective cohort of PV or MF patients at Stanford Medical Center was identified and matched on age, gender, race, Charlson comorbidity index, disease diagnosis, and follow-up time. The main outcome measure was Hazard Ratio (HR) for NMSC (comprised of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)) after ruxolitinib exposure, adjusted for covariates.RESULTS: The study cohort consisted of 564 patients (188 exposed to ruxolitinib for at least 4 weeks, 376 unexposed). Ruxolitinib-exposed PV or MF patients had an adjusted NMSC HR of 2.69 (95% Confidence Interval (CI), 1.03-7.02). In particular, ruxolitinib exposure was associated with SCC, HR=3.24 (95% CI, 1.45-7.22), with non-JAK2 mutated patients showing even higher SCC risk, HR=7.40 (2.54-21.63).LIMITATIONS: Retrospective design.CONCLUSIONS AND RELEVANCE: Our real-world results indicate that SCC risk is increased in PV or MF patients taking ruxolitinib and supports consideration of skin cancer monitoring.

View details for DOI 10.1016/j.jaad.2021.10.004

View details for PubMedID 34648874