Dr. Mesa Discusses the Treatment Landscape for MPNs

Ruben Mesa, MD, director, The Mays Cancer Center, the newly named center of UT Health San Antonio MD Anderson Cancer Center, discusses the treatment landscape for patients with myeloproliferative neoplasms (MPNs).

This is an exciting time for advances in therapy for patients with MPNs, explains Mesa. In the past, the challenge was deciding whether to use hydroxyurea. Ruxolitinib (Jakafi) is a frontline therapy for patients with myelofibrosis and a second-line therapy for patients with polycythemia vera.

Additional JAK inhibitors are coming in the near future, says Mesa. Fedratinib (SAR302503) has been taken off of an FDA hold, as it had success in a phase III study. There were issues in the past regarding concerns of neurologic toxicities, which are being worked through, adds Mesa. What form in which that drug will surface is still unknown, but it could be important for treating these patients, he says.

Pacritinib has demonstrated to be safe and effective for patients with marked thrombocytopenia, and is undergoing testing to find a minimally effective dose. This drug may surface with an indication for patients with significant thrombocytopenia.