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ONCAlert | Upfront Therapy for mRCC

Addressing Ruxolitinib Resistance in Myelofibrosis

Robyn M. Scherber, MD, MPH
Published Online: 8:30 PM, Wed September 12, 2018

Robyn M. Scherber, MD, MPH, physician, The Mays Cancer Center, the newly named center of UT Health San Antonio MD Anderson Cancer Center, addresses the management of patients with myelofibrosis (MF) after failure on ruxolitinib (Jakafi).

Ruxolitinib failure is observed in a broad range of presentations and definitions, and Scherber says that a key difference should specifically be made between ruxolitinib refractory/resistant patients and ruxolitinib progressed/relapsed patients. Scherber says that she evaluates which category a patient falls into once they have failed on ruxolitinib, and then adjusts treatment accordingly.

In patients with refractory or resistant disease, ruxolitinib can be safety continued and may still have benefit. In those with relapsed or progressive disease, single-agent ruxolitinib is often not adequate. For patients with relapsed or progressive disease, a combination approach may increase the impact of ruxolitinib. Ruxolitinib in combination with hypomethylating agents has shown promise, as well as with azacitidine.

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