hydroxyurea

P3, N=340, Active, not recruiting, Merck Sharp & Dohme LLC | Recruiting --> Active, not recruiting

Moreover, we confirmed that PAF1c deficiency increases the cytotoxicity of several DNA-damaging agents, including hydroxyurea (HU), cisplatin (CDDP), methyl methanesulfonate (MMS), and bleomycin (BLM). Unexpectedly, PAF1c depletion confers tolerance specifically to topoisomerase inhibitors, such as camptothecin (CPT), etoposide (ETOP), and doxorubicin (DOX)...Collectively, our findings demonstrate that loss of PAF1c subunits not only promotes genomic instability through R-loop accumulation but also alters cellular responses to DNA-damaging agents, conferring resistance particularly to topoisomerase inhibitors. This study underscores the critical role of PAF1c in maintaining genome stability and provides a rationale for developing new therapeutic strategies in cancer treatment.

Our literature review identified three previously reported cases of HU-associated digital gangrene, though limited to the lower extremities - two in chronic myeloid leukemia (CML) and one in sickle cell disease (SCD). In each case, gangrene developed after prolonged HU exposure, alternative etiologies were not substantiated, and stabilization or clinical improvement followed HU withdrawal. The present case aligns with this pattern while extending the reported phenotype to well-controlled PV and upper-extremity digits. Given the small number of reported cases, the pathophysiology remains incompletely defined and is largely extrapolated from studies of more frequently described HU-associated ulceration, histopathologic reports of HU-related tissue injury, and in vitro studies of HU effects on endothelial and circulating cells. Plausible mechanisms include cumulative endothelial injury, localized thrombo-occlusive microvascular dysfunction, impaired vascular and cutaneous repair, and interaction with PV-related microvascular susceptibility. Clinicians should include HU-associated vasculopathy in the differential diagnosis of otherwise unexplained digital ischemia, as prompt drug cessation may limit progression and improve digit salvage.

P=N/A, N=200, Recruiting, Children's Hospital Medical Center, Cincinnati | Trial completion date: Dec 2026 --> Dec 2030 | Trial primary completion date: Dec 2025 --> Dec 2028

Ropeginterferon alfa-2b-njft (ropeg), a mono-PEGylated interferon-α, showed efficacy and safety in patients with hydroxyurea-intolerant/resistant essential thrombocythemia (ET) in the phase 3 SURPASS-ET largely conducted in Asia. Ropeg showed efficacy and substantial molecular responses with good overall tolerability across a broad ET population. PharmaEssentia.

P4, N=90, Completed, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh | Recruiting --> Completed | Trial completion date: Dec 2024 --> Jan 2026 | Trial primary completion date: Jun 2024 --> Jan 2026

ORR was 57%, 20% and 25% in patients treated by intensive chemotherapy (IC), hypomethylating agents (HMA) and BSC (including low intensity treatments as hydroxyurea and low-dose cytarabine), respectively. We observed poor outcome using IC or HMA encouraging us to propose new clinical trials in this specific subgroup. Only ASCT was able to improve prognosis.

P2, N=50, Recruiting, Step Pharma, SAS | Phase classification: P1 --> P2 | N=20 --> 50 | Trial completion date: Dec 2027 --> Sep 2028 | Trial primary completion date: May 2026 --> Jun 2028

This study provides one of the first extensive characterizations of PV in southern Colombia, confirming internationally recognized clinical features, including advanced age at diagnosis, increased prevalence of cardiovascular comorbidities, and a predominance of high-risk classification. The low rate of finding JAK2 mutations suggests that molecular testing may not be as easy to get as it could be. Even if the treatment followed the guidelines, the risk of recurrence and thrombosis remained, showing that PV is a long-term and worsening condition. These findings highlight the urgent need to expand access to molecular diagnostics, develop tailored risk-adapted medicines, and initiate prospective multicenter studies in Latin America to optimize outcomes and quality of life in PV.

We describe a 71-year-old man with JAK2-positive polycythemia vera (PV) whose hematologic parameters remained suboptimally controlled under hydroxycarbamide treatment...This case demonstrates that additional mutated clones can significantly influence phenotype and disease evolution, highlighting the limitations of stepwise molecular testing. Comprehensive profiling of clonal architecture is essential to refine diagnosis and prognosis, in the NGS era.

Treatment strategies included supportive care, interferon, hydroxyurea, and ruxolitinib. PMF and SMF demonstrate distinct clinical phenotypes despite sharing bone marrow fibrosis as a common endpoint. The mutational landscape highlights the genetic heterogeneity of MF and underscores the importance of integrating clinical, pathological, and molecular information to improve disease characterization and guide individualized management.

P2/3, N=207, Active, not recruiting, Sobi Inc. | Recruiting --> Active, not recruiting