Moving Beyond JAK Inhibitors in Myeloproliferative Neoplasms

Naveen Pemmaraju, MD, associate professor, Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the need to move beyond JAK inhibition when treating patients with myeloproliferative neoplasms (MPNs), which he recently covered in a presentation during the Texas Virtual MPN Workshop.

In the MPN field, no targeted agents were available prior to the development of the JAK inhibitor ruxolitinib (Jakafi). Later, other JAK inhibitors were developed and are considered to be efficacious for the treatment of some patients. Pemmaraju notes that not all patients respond to JAK inhibitors, not all patients are eligible to receive a JAK inhibitor, and some patients are intolerant. Overall, JAK inhibitors do not appear to be curative in MPNs, leaving allogeneic stem cell transplant as the only curative treatment in the space, says Pemmaraju.

The addition of novel agents to a ruxolitinib regiment is the new strategy for patients who cannot derive benefit from ruxolitinib alone. Pemmaraju says, novel combinations are already being explored for the treatment of acute and chronic leukemias, and now is the time to try this strategy in MPNs.

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