Understanding Current Treatment for Myelofibrosis

Dr. Prithviraj Bose, a professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center in Houston, participated in an interview with CURE to provide insight into the current treatment landscape for patients with myeloproliferative neoplasms, a group of rare blood cancers. In particular, he focused on myelofibrosis.

“Myelofibrosis therapy today is still limited to the four JAK inhibitors,” he noted.

These FDA-approved therapies include Jakafi (ruxolitinib), Inrebic (fedratinib), Vonjo (pacritinib), and Ojjaara (momelotinib).

Additionally, Bose discussed how can patients with myelofibrosis can work with their care team to understand their treatment options in another conversation with CURE.

Transcript

Can you walk us through the current treatment landscape for myelofibrosis, and how you decide which therapies are best suited for individual patients?

Myelofibrosis therapy today is still limited to the four JAK inhibitors. However, we do use some unapproved therapies in [certain] situations. For example, interferon can be used for very early disease when the spleen is not enlarged, symptoms are not prominent and there are no cytopenias, with the hope of disease modification.

There are some patients, not too many, who present with just anemia as their main [issue]. In that case, we can use therapies directed purely at anemia. But most patients will eventually need JAK inhibitors because they tend to have some degree of splenomegaly and symptoms.

That is where we really need to be aware of the strengths and weaknesses of the four approved drugs: Jakafi, Inrebic, Vonjo and Ojjaara. It is important to really evaluate the data [of these agents] and try to tailor it [for each individual patient]. For example, with significant anemia, I would typically reach for Ojjaara. Jakafi, however, has a survival advantage, so sometimes you might choose Jakafi and counteract the anemia with another therapy.

A lot of factors go into this decision-making, but the most important thing is to target what the patient needs the most.

Transcript has been edited for clarity and conciseness.

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