Pacritinib vs. Hydroxyurea in Advanced Proliferative Chronic Myelomonocytic Leukemia
Key claim: A randomized clinical trial is comparing pacritinib (twice daily) versus hydroxyurea for up to 48 weeks to determine whether pacritinib offers superior disease control and tolerability in adults with advanced proliferative CMML.
Abstract
The goal of this clinical trial is to learn if pacritinib works better than hydroxyurea to treat advanced proliferative chronic myelomonocytic leukemia in adults. The main questions it aims to answer are:
- Does pacritinib improve disease control compared to hydroxyurea?
- What medical problems do participants have when taking pacritinib or hydroxyurea? Researchers will compare pacritinib to hydroxyurea to see if pacritinib is more effective and better tolerated in people with advanced proliferative chronic myelomonocytic leukemia.
Participants will be randomly assigned to receive either pacritinib twice a day or hydroxyurea for up to 48 weeks.
After treatment ends, participants will be followed for up to one year.
Why this matters
Advanced proliferative CMML sits at the MDS/MPN interface where hydroxyurea has long been the default cytoreductive option despite limited disease-modifying activity. A randomized comparison against pacritinib — whose JAK2/IRAK1 profile targets inflammatory and proliferative signaling implicated in CMML biology — could establish the first evidence-based, mechanism-driven alternative for this subtype’s proliferative phenotype, distinguishing its therapeutic trajectory from dysplastic CMML and from classical MPNs.