MPNs

Naveen Pemmaraju, MD, discusses the need to move beyond JAK inhibition when treating patients with myeloproliferative neoplasms.

Experts in myeloproliferative neoplasms find janus kinase inhibitors to be particularly important to the armamentarium for the treatment of myelofibrosis. With only 2 FDA-approved agents, fedratinib and ruxolitinib, and the inevitability that not all patients will derive benefit, and some will develop resistance, the option of moving beyond JAK inhibition is widely discussed.

Patients with myelofibrosis have complicated pathology and multiple pathways, creating the opportunity to use multiple targeted agents for treatment, but also leading to greater potential for resistance to monotherapy, according to Lucia Masarova, MD.

Standard treatment for accelerated or blast phase myeloproliferative neoplasms consists of hypomethylating agents or intensive induction chemotherapy and transplant. However, newer studies have suggested that accelerated or blast phase MPNs, such as acute myeloid leukemia, can be treated with molecularly driven targeted therapies.

In an interview with Targeted Oncology, Ruben Mesa, director, MD, discussed the role of JAK inhibitors in early myelofibrosis and other promising treatment options coming down the pipeline.

During the 1st Annual Texas MPM Workshop, Aaron Gerds, MD, MS presented on the ruxolitinib in the present and future, as well as the possibilities for moving beyond the JAK-STAT pathway.

Patients considered to have early myelofibrosis are a heterogeneous group for whom disease risk, best treatment strategies, and the probability of mortality are best determined individually by looking at patient’s clinical characteristics and molecular markers together.

Srdan Verstovsek, MD, PhD, discusses the data seen in the phase 2 trial of CPI-0610 with or without ruxolitinib in patients with myelofibrosis.

Ruben Mesa, MD, reviewed a case of a 68-year-old woman with a myeloproliferative neoplasm, during a virtual Case Based Peer Perspectives event.

Ruxolitinib induced clinically meaningful reductions in both spleen size and symptoms for patients with myelofibrosis, including those with low platelet counts.

In an interview with Targeted Oncology, Srdan Verstovsek, MD, PhD, discussed the data from the MANIFEST trial, which evaluated the use of CPI-0610 as treatment of patients with myelofibrosis.

Srdan Verstovsek, MD, PhD, discusses the potential role of CPI-0610 as treatment of patients with myelofibrosis.

The approval of ruxolitinib may have generated an increased awareness around myelofibrosis, ultimately improving the overall management of this patient population.

In an interview with Targeted Oncology, Claire Harrison, MD, FRCP, FRCPath, discussed results from the combination of navitoclax and ruxolitinib, as explored in a phase 2 study.

During the Virtual 25th Congress of the European Hematology Association (EHA), a group of physicians described their experiences and recommendations for managing patients with myeloid malignancies during the COVID-19 pandemic and after.

These data suggest that screening for pulmonary hypertension is warranted in patients with a Philadelphia chromosome-negative myeloproliferative neoplasm, both at the time of diagnosis and during follow-up.

“RASMT associated with adverse phenotypic features were concluded to be an independent predictor of inferior overall survival and were associated with a higher cumulative incidence of leukemic transformation."

Naveen Pemmaraju, MD, discusses the clinical implications of a retrospective analysis of 26 patients with myelofibrosis who received benefit from ruxolitinib when it was rechallenged.

"This interim analysis demonstrated ropeginterferon in low-risk patients is more efficacious in keeping the hematocrit [at target levels]. In addition, we get a better quality of life and the target was reached with a reduction of phlebotomy needs."

"We believe ropeginterferon alfa-2b could become an important new therapeutic tool and look forward to engaging with the regulators in our efforts to introduce this option to the underserved PV community in the United States."

“In this study, we evaluated ruxolitinib as a bridge, relapse, and GVHD prevention agent in patients with myelofibrosis. The regimen was well tolerated, with an acceptable rate of organ toxicity."

A new analysis of nearly 600 patients with myelofibrosis found patients who take ruxolitinib progress to blast phase at approximately the same rates as those who are ruxolitinib-naïve.

Momelotinib for the treatment of patients with myelofibrosis may address concerns with the development of cytopenias, an issue no approved therapy has been able to solve.

Corey S. Cutler, MD, MPH, discusses the current treatment options for patients with chronic graft-versus-host-disease and highlighted some upcoming research.

In an interview with Targeted Oncology, Verstovsek, medical oncologist and professor, Department of Leukemia, University of Texas MD Anderson Cancer Center, discussed mutational profiling for myelofibrosis and how the information obtained can be valuable for clinical management of the disease.