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Does Ruxolitinib Exposure Increase NMSC Risk in Polycythemia Vera, Myelofibrosis?

Hazard ratio for nonmelanoma skin cancer was 2.69 for ruxolitinib-exposed patients; hazard ratio higher for SCC

By Dermsquared Editorial Team | October 27, 2021

For patients with polycythemia vera (PV) or myelofibrosis (MF), exposure to the Janus Kinase (JAK) 1/2 inhibitor ruxolitinib is associated with an increased risk for nonmelanoma skin cancer (NMSC), according to a study published online Oct. 10 in the Journal of the American Academy of Dermatology.

John Q. Lin, from Stanford University School of Medicine in Redwood City, California, and colleagues examined the risk for developing NMSC after ruxolitinib exposure in patients with PV or MF in a 10-year retrospective cohort of 564 patients (188 exposed to ruxolitinib for at least four weeks; 376 unexposed).

The researchers found that the incident rate of NMSC was 72.12 and 33.27 per 1,000 person-years with and without ruxolitinib exposure, respectively. PV or MF patients exposed to ruxolitinib had an adjusted hazard ratio of 2.69 for NMSC. Ruxolitinib exposure was more strongly associated with squamous cell carcinoma (SCC; hazard ratio, 3.24); higher SCC risk was seen for non-JAK2 mutated patients (hazard ratio, 7.40).

"Recently, the package insert for ruxolitinib was updated to include the warning of 'risk of nonmelanoma skin cancer', with the recommendation to 'perform periodic skin examinations' for MF or PV patients," the authors write. "Our long-term data from clinical practice provides independent support outside of the trials setting to support this recommendation in PV and/or MF patients."

Several authors disclosed financial ties to the biopharmaceutical industry.

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