Firas El Chaer, MD, an assistant professor of medicine, Division of Hematology/Oncology, Department of Medicine at Emily Couric Clinical Cancer Center, UVA Health, discusses the role of next-generation sequencing (NGS) in myeloproliferative neoplasms (MPNs).

Utilizing NGS is an important step in the treatment of patients with MPNs, says El Chaer. For example, treatment selection for patients with primary myelofibrosis historically relied on the Dynamic International Prognostic Scoring System. Currently, scoring is determined by a patient’s mutational profile beyond 

As is the case in other hematologic malignancies, such as leukemia, NGS can provide prognostic information to aid in treatment planning for patients with MPNs. As such, NGS should be incorporated into the treatment paradigm for patients in this space, El Chaer concludes.

Videos

Firas El Chaer, MD, discusses the role of next-generation sequencing (NGS) in myeloproliferative neoplasms.  



Dr. El Chaer on the Role of Next-Generation Sequencing in MPNs 

Firas El Chaer, MD, an assistant professor of medicine, Division of Hematology/Oncology, Department of Medicine at Emily Couric Clinical Cancer Center, UVA Health, discusses the potential utility of combination strategies with ruxolitinib (Jakafi) in patients with myeloproliferative neoplasms (MPNs). 

 ruxolitinib has been approved by the FDA for use in 

select patients with polycythemia vera and myelofibrosis

, El Chaer explains. However, early data suggest that combining ruxolitinib with hypomethylating agents, such as decitabine, can improve responses for patients with accelerated- or blast-phase disease.

Additionally, combining ruxolitinib with other agents, including BCL-2 inhibitors such as venetoclax (Venclexta) or navitoclax, may have potential in this patient population, concludes El Chaer. 

Firas El Chaer, MD, discusses the potential utility of combination strategies with ruxolitinib in patients with myeloproliferative neoplasms.  


Dr. El Chaer on the Potential for Combination Strategies With Ruxolitinib in MPNs 

Firas El Chaer, MD, assistant professor of medicine, Division of Hematology/Oncology, Department of Medicine, Emily Couric Clinical Cancer Center, UVA Health, discusses the limitations of JAK inhibitors in myelofibrosis.

Currently, ruxolitinib (Jakafi) and fedratinib (Inrebic) are approved for the treatment of patients with myelofibrosis, El Chaer explains. Typically, these agents are used to treat the symptoms associated with myelofibrosis, such as B symptoms and splenomegaly, says El Chaer.

However, JAK inhibitors do not offer curative benefit to patients with myelofibrosis and the survival advantage associated with these agents is modest, El Chaer says. As such, the majority of patients require a bone marrow transplant. 

To increase the utility of JAK inhibitors, combination strategies with ruxolitinib or fedratinib and other agents, such as BCL-2 inhibitors or PIM kinase inhibitors, are being investigated in ongoing clinical trials, concludes El Chaer.

Firas El Chaer, MD, discusses the limitations of JAK inhibitors in myelofibrosis.  



Firas El Chaer, MD

Articles

Dr. El Chaer on the Role of Next-Generation Sequencing in MPNs

Dr. El Chaer on the Potential for Combination Strategies With Ruxolitinib in MPNs

Dr. El Chaer on the Limitations of JAK Inhibitors in Myelofibrosis