Evaluating the Next Steps for Research in Myelofibrosis

Laura Michaelis, MD, an associate professor at the Medical College of Wisconsin, discusses the next steps for research in the treatment of myelofibrosis (MF) following the addition of fedratinib (Inrebic) to the armamentarium of JAK inhibitors.

Since ruxolitinib (Jakafi) was brought to market, research has come a long way, Michaelis says. However, some unanswered questions still exist, such as how necessary is it to eradicate the clone? With better stratification systems now and patients with MF living longer than before, additional treatment may not be needed. There is a category of patients that can be observed, she notes.

If a patient presents with higher-risk disease, Michaelis asks how are we modifying the disease? How are we getting to the root of it? JAK inhibitors may not be the answer, although they are good for splenic response and symptom reduction. Whether or not more drugs need to be used earlier, including in patients who have lower risk of disease, and whether additional drugs are needed that tackle the clone at a lot of different areas of vulnerability are 2 remaining questions to be addressed.