Dr. Gerds on Emerging Agents in Myelofibrosis

Aaron T. Gerds, MD, MS, assistant professor in medicine (hematology and medical oncology), physician, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, assistant professor, Department of Medicine, School of Medicine, member, Developmental Therapeutics Program, Case Comprehensive Cancer Center, Case Western Reserve University, discusses emerging agents in myelofibrosis.

Unlike other hematologic malignancies like chronic myeloid leukemia, chronic lymphocytic leukemia, and acute lymphoblastic lymphoma, the paradigm of myelofibrosis comprises limited treatment options, Gerds explains. Currently, only 2 agents, ruxolitinib (Jakafi) and fedratinib (Inrebic) are FDA approved for use in patients with myelofibrosis.

However, the field is rich with emerging agents that will change treatment patterns, Gerds explains. For example, the JAK inhibitors pacritinib and momelotinib are likely to be FDA approved within a year. Moreover, a press release reported that pivotal phase 3 MOMENTUM trial (NCT04173494), which is evaluating momelotinib vs danazol in patients with myelofibrosis who are symptomatic and anemic, met its primary end point, as well as all key secondary end points.

Other agents, such as the BET inhibitor pelabresib and the BCL-2 inhibitor navitoclax, are emerging for use in myelofibrosis, Gerds says. Ultimately, these novel agents are targeting pathways that are independent of the JAK/STAT pathway, which is traditionally used to augment responses in myelofibrosis, Gerds concludes.