Myeloproliferative Neoplasms | Oncology Today with Dr Neil Love: Myeloproliferative Neoplasms Edition

A virtual roundtable discussion with noted investigators Prof Claire Harrison and Dr John Mascarenhas for a review of recent innovations in the treatment of myeloproliferative neoplasms. Biology of myeloproliferative neoplasms (MPN); mutational landscape and implications for prognosis and therapy (00:00) Diagnosis and risk stratification of MPN (3:34) Pathophysiology of MPN and therapeutic approach to patients with MPN (6:41) Case (Prof Harrison): A man in his early 60s with symptomatic primary myelofibrosis (MF) and mutations in JAK2, ASXL1, EZH2 and TET2 receives ruxolitinib as first-line therapy (9:39) Dosing and quality of life with ruxolitinib (11:58) Case (Dr Mascarenhas): A man in his early 60s receives ruxolitinib for symptomatic primary MF and experiences a return of symptoms 3 years later (14:14) Bone pain associated with MF; use of bone marrow biopsy to monitor disease progression (16:41) Design, eligibility criteria and results of the Phase III COMFORT-I and COMFORT-II studies evaluating ruxolitinib for patients with MF (21:16) A pooled analysis of overall survival in the COMFORT-I and COMFORT-II trials of ruxolitinib for the treatment of MF (23:53) Predictors of overall survival benefit with ruxolitinib (26:01) Biologic rationale for the survival benefit with ruxolitinib in MF (28:50) Perspective on the use of ruxolitinib in patients with MF in the absence of symptoms (32:56) Side-effect profile of ruxolitinib (36:36) Management of cytopenias associated with ruxolitinib (40:33) Potential correlation between JAK inhibitor therapy and second primary cancers (42:13) Spectrum of activity and ongoing investigation of novel JAK inhibitors in MF (45:21) Efficacy of fedratinib, pacritinib and momelotinib in patients with MF (48:08) Activity and tolerability of fedratinib for MF (50:45) Results of the single-arm, Phase II JAKARTA-2 study evaluating fedratinib in patients with MF previously treated with ruxolitinib (52:51) Response to fedratinib in the JAKARTA-2 study; ongoing Phase III studies of fedratinib in the second-line setting for MF (55:49) Case (Prof Harrison): A man in his late 60s with triple-negative primary MF experiences a good response to fedratinib as second-line therapy on the JAKARTA-2 trial (1:00:13) Case (Dr Mascarenhas): A man in his early 70s with primary MF and cytopenias experiences an improvement in symptoms and reduction in spleen size after treatment with pacritinib on the PERSIST-2 study (1:03:23) Potential role of fedratinib, pacritinib and momelotinib in the management of MF (1:05:11) Ongoing investigation of erythroid maturation agents in patients with MF (1:09:09) Perspective on the role of luspatercept and sotatercept in the management of MF (1:11:09) Case (Prof Harrison): A man in his late 50s with severe pruritus associated with polycythemia vera (PV) experiences a dramatic relief of symptoms with ruxolitinib (1:13:11) Efficacy of ruxolitinib in managing pruritus associated with PV (1:15:39) Case (Dr Mascarenhas): A woman in her late 60s with essential thrombocythemia (ET) refuses cytoreductive therapy (1:18:24) Effect of age and mutational status on the decision to treat ET (1:21:18) CME information and select publications