Cutler CS, Lee SJ, Arai S, et al. Belumosudil for Chronic Graft-versus-Host Disease (cGVHD) After 2 or More Prior Lines of Therapy: The ROCKstar Study. Blood. 2021; (doi: 10.1182/blood.2021012021).
Belumosudil, an oral selective rho-associated coiled-coil-containing protein kinase-2 (ROCK2) inhibitor, effectively reduced symptoms of chronic graft-versus-host disease (cGVHD), according to new research. The therapy reduces type 17 and follicular helper T cells by downregulating signal transducer and activator of transcription 3. It also upregulates signal transducer and activator of transcription 5 to augment T cells. In the Phase II multicenter study, 132 cGVHD patients who had previously received 2-5 lines of therapy were equally randomized to receive belumosudil 200 mg once or twice a day. The average follow-up was 14 months. The best overall response rate to the once and twice daily dosing was 74% and 77%, respectively, with all subgroups demonstrating high response rates. Complete responses were seen in all affected organs. The median duration of response was 54 weeks, and 44% of subjects have continued therapy for ≥1 year. Reduced symptoms for belumosudil 200 mg once a day and twice a day were observed in 59% and 62% of patients, respectively. The adverse events (AEs) reported were consistent for those expected in patients who received corticosteroids and other immunosuppressants, with 16 (12%) halting treatment due to possible drug-related AEs.