Evidence Supports Rechallenging of JAK Inhibitors in Myelofibrosis

Naveen Pemmaraju, MD, associate professor in the Department of Leukemia of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses the clinical implications of a retrospective analysis of 26 patients with myelofibrosis who received benefit from ruxolitinib (Jakafi) when it was rechallenged.

The take home point from this analysis is that ruxolitinib discontinuation or interruption that is followed by ruxolitinib reexposure is somewhat common in the community setting. In this group of patients, a sizable percentage experienced potential clinical benefit from reexposure to the JAK inhibitor, Pemmaraju says.

The data from this study set us up for a number of different concepts for rechallenging patients with the same JAK inhibitor, Pemmaraju says. There are clinical trials evaluating the benefit of sequential or subsequent JAK inhibitor therapies. As these agents are approved, determining the optimal dosing of the initial JAK inhibitor will be important for selecting an appropriate dose of the subsequent agent.

Pemmaraju says 1 important question that remains is how to sequence these agents for patients with myelofibrosis. This analysis brought forward this question, and it will have to be addressed in the future.

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