Rampal Navigates the Landscape of JAK Inhibitors in Myelofibrosis

Raajit K. Rampal, MD, PhD, hematologic oncologist at Memorial Sloan Kettering Cancer Center, discusses the established role of JAK inhibition for the treatment of myelofibrosis at the Fifth Annual Miami Cancer Institute Global Summit on Immunotherapies for Hematologic Malignancies, hosted by Dr. Guenther Koehne and Miami Cancer Institute.

While ruxolitinib (Jakafi) is the established JAK inhibitor, newer JAK inhibitors, like fedratinib (Inrebic) and momelotinib (Ojjaara), are emerging in the treatment of myelofibrosis.

Here, Rampal provides an overview on the JAK inhibitors being utilized for myelofibrosis treatment and discusses how experts are managing potential adverse effects associated with JAK inhibitor therapy, based on his presentation.

Transcription:

0:09 | The newer JAK inhibitors seem to have different profiles in terms of what they can do and how we can use them. Drugs like pacritinib [Vonjo] can be used regardless of platelet counts, so it gives us another option. And then we have drugs like momelotinib, but also pacritinib, that are useful in patients with anemia, particularly transfusion-dependent anemia. Then fedratinib can be used in the first-line, but there is also good data for using it in the second-line after ruxolitinib, so these are not all the same. They have different uses in different patients.

0:38 | It really depends on being aware of the potential adverse events and mitigating them early on. Many of these drugs, pacritinib and fedratinib as examples, cause [gastrointestinal] toxicity. So knowing that you need to give patients antidiarrheal medications when they start their treatment is important. Things like being aware of Wernicke encephalopathy with fedratinib, but also being aware of the infectious complications that can arise with things like ruxolitinib and momelotinib.

1:07 | Switching from 1 JAK inhibitor to another, there is some data for that in some patients, but I think we have to come up with different and newer therapies. I think that is really where clinical trials enter.