Laura Michaelis, MD

Laura Michaelis, MD, an associate professor at the Medical College of Wisconsin, discusses the next steps for research in the treatment of myelofibrosis (MF) following the addition of fedratinib (Inrebic) to the armamentarium of JAK inhibitors.

Since ruxolitinib (Jakafi) was brought to market, research has come a long way, Michaelis says. However, some unanswered questions still exist, such as how necessary is it to eradicate the clone? With better stratification systems now and patients with MF living longer than before, additional treatment may not be needed. There is a category of patients that can be observed, she notes.

If a patient presents with higher-risk disease, Michaelis asks how are we modifying the disease? How are we getting to the root of it? JAK inhibitors may not be the answer, although they are good for splenic response and symptom reduction. Whether or not more drugs need to be used earlier, including in patients who have lower risk of disease, and whether additional drugs are needed that tackle the clone at a lot of different areas of vulnerability are 2 remaining questions to be addressed.

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Laura Michaelis, MD, discusses the next steps for research in the treatment of myelofibrosis following the addition of fedratinib to the armamentarium of JAK inhibitors.

Evaluating the Next Steps for Research in Myelofibrosis

Laura Michaelis, MD, associate professor of medicine, Medical College of Wisconsin, discusses how to select patients with either polycythemia vera (PV) or essential thrombocythemia (ET) for cytoreductive therapy.

According to Michaelis, if a patient with PV is over the age of 60 or has had a prior arterial or venous clot, she will give these patients cytoreductive treatment. However, she does not treat patients with ET the same way.

Laura Michaelis, MD, discusses how to select patients with either polycythemia vera or essential thrombocythemia for cytoreductive therapy.

Selecting Cytoreductive Therapy for Patients with PV or ET

Laura Michaelis, MD, associate professor of medicine, Medical College of Wisconsin, discusses thrombotic risk for patients with essential thrombocythemia (ET) and polycythemia vera (PV).

There are certain early molecular driver mutations that occur in myeloproliferative neoplasms that can predict thrombotic risk in patients. The risk for a patient with any given driver mutation differs between ET, PV, and myelofibrosis. Michaelis says that one of the early questions since the

mutation was described is, why do some people act one way, while others act another?

One answer seems to be that a patient&rsquo;s thrombotic risk is based on the presence of a

treatment for ET is changing, reflecting the entrance into the genomic era, according to Michaelis. Decision-making for patients is different now compared to 3 years ago based on this information. Importantly, this information means that patients with ET who do not have a

Laura Michaelis, MD, associate professor of medicine, Medical College of Wisconsin, discusses thrombotic risk for patients with essential thrombocythemia and polycythemia vera.

Laura Michaelis, MD | Authors

Articles

Evaluating the Next Steps for Research in Myelofibrosis

Selecting Cytoreductive Therapy for Patients with PV or ET

Understanding Thrombotic Risk in ET and PV