Dr Klisovic on the Impact of Momelotinib on Myelofibrosis Management

Rebecca Klisovic, MD, chief medical information officer, University Hospitals Seidman Cancer Center consortium, discusses updates with JAK inhibitors in myelofibrosis, highlighting factors that inform JAK inhibitor selection in this space following an OncLive State of the Science Summit™ (SOSS) on hematologic malignancies.

In September 2023 the FDA approved momelotinib for patients with intermediate or high-risk myelofibrosis, including primary myelofibrosis or secondary myelofibrosis, and anemia. The regulatory decision was supported by findings from the phase 3 MOMENTUM trial (NCT04173494) and data for a subpopulation of patients with anemia in the phase 3 SIMPLIFY-1 trial (NCT01969838). Momelotinib is currently the first and only therapy indicated for patients with anemia and myelofibrosis.

The approval of momelotinib adds to the growing array of treatment options for myelofibrosis, many of which have subtle differences in efficacy and safety profiles that may inform treatment selection, Klisovic states. This offers clinicians the ability to tailor therapy based on specific patient characteristics and needs, she adds. In a panel discussion at the SOSS event, Klisovic and colleagues expanded on the use of momelotinib and its role as a preferred choice for patients with myelofibrosis who experience challenges with anemia, among other topics. The positive data on anemia outcomes from clinical trials supported this decision, positioning momelotinib as an effective therapeutic option in this subgroup of patients, Klisovic summarizes.

In clinical practice, the selection of momelotinib upfront may be driven by the presence of anemia as a predominant toxicity, with the drug demonstrating efficacy in addressing this specific aspect of the disease, Klisovic continues. For patients with platelet counts lower than 25,000/µL, alternative JAK inhibitors such as pacritinib (Vonjo) may be favored due to safety profiles related to thrombocytopenia, she states.

Overall, momelotinib has expanded the treatment armamentarium for myelofibrosis and underscores the importance of personalized medicine in this setting, Klisovic concludes. With multiple treatment options available, clinicians can now optimize therapy based on individual patient characteristics and treatment goals, offering a more tailored approach to managing this complex disease.