PV at ASCO 2026 / Polycythemia Vera 06/08/2026

Current Treatment Paradigms and the Emerging Role of Ropeginterferon Alfa-2b-njft in PV

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Key Points

  • Aspirin, phlebotomy, and hydroxyurea remain foundational therapies for polycythemia vera (PV) but primarily address thrombotic risk and hematocrit control.
  • Hydroxyurea is effective for many patients but may be limited by adverse effects and loss of disease control over time.
  • Long-term data from PROUD-PV and CONTINUATION-PV support durable hematologic responses with ropeginterferon alfa-2b-njft.
  • Treatment goals are increasingly shifting toward disease modification and prevention of myelofibrosis and leukemic transformation.

Oncology Brothers podcast cohosts Rahul Gosain, MD, MBA, of Wilmot Cancer Institute, and Rohit Gosain, MD, of Roswell Park Comprehensive Cancer Center, were joined by Aaron Gerds, MD, of Cleveland Clinic; Anthony Hunter, MD, of Winship Cancer Institute of Emory University; and Anand Patel, MD, of the University of Chicago, for a Clinical Insights discussion coinciding with the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. The panel examined the current treatment landscape, including traditional therapies, the expanding role of ropeginterferon, and the growing emphasis on long-term disease modification. 

PV management has long relied on aspirin, phlebotomy, and cytoreductive therapy to reduce thrombotic risk, with hematocrit control below 45% remaining a key benchmark. Dr. Gerds noted that although aspirin and phlebotomy have been standards of care for decades, they primarily target thrombosis risk reduction rather than true disease modification.

Hydroxyurea remains a common first-line cytoreductive therapy, particularly for older patients who prefer oral therapy. Dr. Patel noted that hydroxyurea can effectively control blood counts and offers flexible dosing adjustments but does have limitations. Some patients experience chronic low-grade adverse effects such as nausea and taste changes; others develop more significant toxicities, including ulcerations. Disease progression over time may also make blood count control more difficult despite dose optimization.

Interest has shifted toward interferon-based therapies, particularly ropeginterferon, which has demonstrated potential for deeper disease modification. Dr. Hunter reviewed data from the PROUD-PV and CONTINUATION-PV studies, which compared ropeginterferon with hydroxyurea. Although early hematologic responses were comparable between treatment arms, longer-term follow-up revealed more durable hematologic control among patients receiving ropeginterferon.