ASH 2014 Coverage: Encouraging MPN Treatment News

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Topics include: Treatment

During the 2014 American Society of Hematology (ASH) annual meeting, Dr. Bart Scott from Seattle Cancer Care Alliance joined Patient Power to share encouraging news for those living with myeloproliferative neoplasms (MPNs). Dr. Scott provided an overview of all of the treatment news, including updates on JAK inhibitors in development, ruxolitinib for polycythemia vera (PV), pegylated interferon and telomerase inhibitors, among many others. Dr. Scott also spoke about the necessity of clinical trials in driving research forward and for improving care for everyone.

This program is sponsored by Patient Empowerment Network, which received an educational grant from Incyte Corporation.

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

Hello, and welcome to Patient Power on location in San Francisco at the American Society of Hematology meeting.  I’m Andrew Schorr with Dr. Bart Scott, who is the director of hematologic malignancies at the Seattle Cancer Care Alliance.

Dr. Scott, as you know, I’m a patient living with myelofibrosis.  I hang on every word that goes on here.  I’m going to hang on every word now. Is there encouragement for those of us living with myelofibrosis?

Dr. Scott:              

Absolutely.  As you know, a new drug was approved recently, ruxolitinib (Jakafi®) , for patients with myelofibrosis, and a Phase III randomized trial showed that patients had improvement in their quality of life, reduction in spleen size, and there was also improvement in overall survival.  Interestingly, that drug was just FDA approved for polycythemia vera, I think it was on Friday, so just yesterday.  There are new drugs coming along all the time.

Andrew Schorr:                  

Let’s talk about the ruxolitinib or Jakafi approval for PV.  We have many viewers who have that as well.  How do they know whether that’s right for them?  Is it a certain group of PV patients?

Dr. Scott:              

It is.  It’s indicated for patients with PV who require cytoreductive therapy.  That would primarily be hydroxyurea (Hydrea®) but who also failed to respond to or are intolerant to Hydrea. So it’s really meant for those patients with polycythemia vera who are on hydrea who are having problems tolerating it, or they’re not responding to it.

Andrew Schorr:                  

Is this approval a good development?

Dr. Scott:              

Absolutely.  It increases armamentarium to treat all patients, and there are further trials that are being done.  Tosedostat is an interesting drug that people are interested in.  Then there’s a pegylated interferon that’s being compared head to head upfront as cytoreductive therapy compared to Hydrea, so there are a lot of interesting developments.

Andrew Schorr:                  

Okay.  Now other JAK2 inhibitors, so we have ruxolitinib, and I think there’s one called pacritinib, and one called momelotinib, and maybe there are even others in development.  Where would those come in if they pay off, just more options for a wider array of patients?

Dr. Scott:              

Well, maybe it’s a little bit more than that actually, because not all of these JAK inhibitors are created equally.  They each have a little bit better inhibition of certain types of JAK.  There are different types of JAK that are active in myeloproliferative neoplasms.  There’s JAK1 and JAK2.

Momelotinib, for instance, appears to have less cytopenias and maybe more activity in some of the constitutional symptoms like night sweats and fever.  Right now, momelotinib is being compared head to head to ruxolitinib in a Phase III randomized trial.  The potential advantage of momelotinib is that it’s a once-a-day drug.  Another potential advantage is that it may not cause as much thrombocytopenia.  Again, that’s what this trial is designed to answer, so hopefully we’ll know that soon.

I think from the patient’s perspective, it’s important for them to know that just because you’re on one JAK inhibitor and that didn’t work, that doesn’t mean the other JAK inhibitors are futile because they’re not the same types of drugs.

Andrew Schorr:                  

Okay.  One last area I want to ask you about is those of us with these illnesses, and myelofibrosis certainly, know we have scarring in our bone marrow.  There’s a paper being presented here related to further data related to whether a drug telomerase inhibitor.  Where do we stand with the whole idea of scarring in the bone marrow, not about the JAK but about this other approach?

Dr. Scott:

I think that’s very interesting, and there are abstracts that are dealing with that.  They’ve been able to show that this drug may inhibit the scar tissue formation.  It may actually reverse it.  I just think time is going to tell with that, and you need more information before we know for sure.

Pegylated interferon is another drug, PEGASYS®, that has been shown to potentially reduce fibrosis and reverse fibrosis.  Again, this is very early data—not a lot of patients yet.  I think we need more information to know for sure if these drugs are actually going to reverse fibrosis.

Andrew Schorr:                  

Okay.  As I always ask you now, for MPN patients with all this development underway, you’re involved in a lot of clinical trials; your peers at other research centers, patients should consider it.

Dr. Scott:              

Absolutely.  Clinical trials are what drive research.  It’s what makes the treatment advance.  It improves care for everyone.

Andrew Schorr:                  

Dr. Bart Scott, thank you for being with us.  As a patient living with one of these MPNs, I take great encouragement from what you’re saying.

Dr. Scott:              

Thank you.

Andrew Schorr:                  

All right.  Andrew Schorr on location at the American Society of Hematology meeting, listening to every word, as I’m sure you are, too.  We’ll have more reports on the MPNs in the latest news, so be sure to sign up for alerts on our website. Remember, knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on April 21, 2015