Dr Desai on Future Research Directions in MPN and Other Hematologic Malignancies

“Gone are the days of [exclusively] treating patients with hematologic malignancies with chemotherapy. We really need to understand the microenvironment and the signaling cascades through which driver mutations work.”

Ruchi J. Desai, MD, an assistant professor in the Division of Hematology, Oncology, and Palliative Care at the Virginia Commonwealth University (VCU) School of Medicine as well as a hematologist/oncologist in the Department of Internal Medicine at VCU Health, discussed future research areas of interest in myeloproliferative neoplasms (MPNs) and other hematologic malignancies.

Desai emphasized that the era of treating patients with hematologic malignancies exclusively with chemotherapy is drawing to a close. Investigators need to perform further research to understand the microenvironment and the signaling cascades through which driver mutations function, she added. Additional pragmatic treatment combinations are also needed in order to minimize therapeutic toxicity and better induce remissions for patients, she said.

As knowledge in the field continues to grow in terms of understanding disease biology, better definitions of disease remission and cure will also be developed, Desai said. These definitions are currently lacking in many disease states.

During a recent OncLive State of the Science Summit on hematologic malignancies, which took place on October 15, 2025, Desai discussed JAK inhibitors for the treatment of patients with MPNs, specifically myelofibrosis and of polycythemia vera (PV). During her presentation, she outlined findings from several studies, including the phase 3 RESPONSE trial (NCT01243944) of ruxolitinib (Jakafi) in patients with PV, the phase 2 REALISE study (NCT02966353) of ruxolitinib in patients with myelofibrosis and anemia, and the phase 2 MAJIC-PV study (NCT01243944) of ruxolitinib vs best available therapy in patients with PV. She also discussed findings with other JAK inhibitors for the treatment of patients with MPNs, such as momelotinib (Ojjaara) and fedratinib (Inrebic).