Real-world treatment patterns, outcomes, and healthcare resource use for myelofibrosis in Brazil: Subgroup analysis of the METER study

Background The METER study (NCT05444972) described real-world treatment patterns and outcomes for myelofibrosis across 14 countries. Given the potential regional variability, the present analysis evaluates the Brazilian cohort within METER to investigate local treatment approaches and patient results. Methods This subanalysis of the METER study included all patients enrolled in Brazil, based on the same eligibility criteria as in the global study. The primary objective was to describe real-world treatment patterns for myelofibrosis. Main results Of 50 eligible patients enrolled in Brazil, 37 (74%) presented with primary myelofibrosis. At diagnosis, nine (20.9%) individuals had high-risk and 14 (32.6%) intermediate-2 risk disease, mostly using the Dynamic International Prognostic Scoring System (DIPSS) criteria. Among patients with available data (n = 18), 50% had a high-risk mutation at diagnosis. Hydroxyurea was the most frequent initial therapy (n = 32; 64%), followed by ruxolitinib (n = 12; 24%). A total of 23 patients (46%) had discontinuation or change of initial therapy, with a median overall duration of first-line treatment of 29.9 months (95% confidence interval: 21.5 to not estimable). The median overall survival from index date was 45.5 months (95% confidence interval: 28.5 to not estimable), with 1- and 2-year survival rates of 87.3% and 74.7%, respectively. Conclusion The treatment patterns in Brazil reflect insufficient access to novel agents. Whether the shorter observed median overall survival compared with the overall METER study is a consequence of insufficient access to treatment or of different biological features warrants further investigation.