Andrew Kuykendall, MD

Panelists discuss the patient and disease characteristics influencing the decision to dose-reduce ruxolitinib vs switching therapy. They share their typical sequencing approach after first-line ruxolitinib, including whether a washout period or overlap is required.

Panelists discuss how they define “ruxolitinib failure” and a suboptimal response, when they consider switching from first-line ruxolitinib, and how they differentiate between myelofibrosis-induced and JAK-induced cytopenias.

Andrew Kuykendall, MD, discusses the advantages of treatment with momelotinib vs older-generation JAK inhibitors in myelofibrosis.

Panelists discuss the latest data on pacritinib’s effects on anemia and bicytopenia, and share their treatment approaches for patients with myelofibrosis who present with both thrombocytopenia and anemia.

Panelists discuss how frequently patients with newly diagnosed myelofibrosis present with moderate or severe thrombocytopenia or both anemia and thrombocytopenia. They discuss how these factors and other disease characteristics like spleen size and constitutional symptoms influence their treatment approach and selection of JAK inhibitors.

Andrew Kuykendall, MD, and Raajit K. Rampal, MD, PhD, conclude that the increasing complexity in myelofibrosis treatment options, including multiple JAK inhibitors and emerging combination therapies, signals an exciting era of individualized care, yet underscores the need for reevaluating study end points to enhance patient outcomes further.

Andrew Kuykendall, MD, emphasizes the importance of individualizing therapy for patients with myelofibrosis, focusing on improving quality of life and addressing specific issues like anemia and spleen volume, with the understanding that these treatments are palliative and goals should be revisited regularly.

Raajit K. Rampal, MD, PhD, discusses choosing among JAK inhibitors based on specific patient needs, such as platelet counts and anemia, emphasizing the importance of using the full dose for best efficacy and how different scenarios might influence the choice and sequencing of these drugs in practice.

Andrew Kuykendall, MD, discusses the efficacy and adverse effects of fedratinib, highlighting its potential in the second-line setting for patients resistant to ruxolitinib, with updates from FREEDOM-2 emphasizing manageable gastrointestinal tolerability concerns.

Drs Rampal and Kuykendall highlight the benefits of pacritinib for patients with low platelet counts, as evidenced by the PERSIST-2 study, and momelotinib for patients with anemia, as shown in the MOMENTUM Phase 3 Study, focusing on their efficacy in spleen volume reduction and symptom relief in patients with myelofibrosis.

Andrew Kuykendall, MD, and Raajit K. Rampal, MD, PhD, reflect on the future of combination therapies in treating myelofibrosis, emphasizing the need to align study endpoints with treatment goals and highlighting the potential of various combinations based on promising preclinical and early phase study results.

Andrew Kuykendall, MD, and Raajit K. Rampal, MD, PhD, discuss luspatercept with or without ruxolitinib for the treatment of anemia in patients with myelofibrosis. The combination has demonstrated promise in reducing transfusion dependency, as seen in data from ACE-536-MF-001, with ongoing phase 3 trials.

Andrew Kuykendall, MD, highlights the potential of selinexor plus ruxolitinib in JAK inhibitor-naïve patients with MF based on promising response rates in XPORT-MF-034 updated results, with plans for a phase 3 study. He also noted the need to manage nausea as a adverse effect.

Raajit K. Rampal, MD, PhD, discusses promising data on navtemadlin plus ruxolitinib for patients with myelofibrosis who had suboptimal responses to ruxolitinib, showing significant improvements in spleen and symptom responses, with further phase 3 studies anticipated.

Andrew Kuykendall, MD, reviews data from TRANSFORM-1 on navitoclax plus ruxolitinib for untreated myelofibrosis, highlighting consistent response rates, no significant symptom improvement with the combination, and challenges managing thrombocytopenia caused by navitoclax, despite its activity and potential as a second-line treatment option.

Andrew Kuykendall, MD, and Raajit K. Rampal, MD, PhD, discuss how the combination of the BET inhibitor pelabresib and the JAK inhibitor ruxolitinib led to greater reductions in spleen size and symptoms compared to ruxolitinib alone in JAK inhibitor-naïve patients with intermediate- or high-risk myelofibrosis in the MANIFEST and MANIFEST-2 trials, with an acceptable safety profile, providing evidence that targeting multiple inflammatory pathways could lead to better disease control.

Andrew Kuykendall, MD, and Raajit K. Rampal, MD, PhD, discuss how JAK inhibitors have reduced spleen size (splenomegaly) and constitutional symptoms like fatigue and fever in patients with myelofibrosis but that there is still room for improvement in treating other aspects of the disease like anemia and bone marrow fibrosis. They also share insights about the potential for combination therapies that target multiple pathways.

Experts discuss how treatments, either monotherapy or combination, may impact the treatment landscape for MF and how they might choose among the new agents.

Panel experts comment on the role of combination therapies in MF and debate if these therapies will be the new standard of care.

Faculty offer insights into the future of PV management as well as unmet needs.

Faculty discuss the best strategies to monitor patients who are receiving treatment of MF as well as commenting on when it might be appropriate to switch therapies.

Expert oncologists provide insights into how they might manage patients who present with anemia and myelofibrosis in their practice.

Overview of the current FDA approved treatment options for the management of myelofibrosis as well as reviewing recent updates from ASH 2023 on the SIMPLIFY and PERSIST trials.

Panel experts comment on the role of transplant in patients with myelofibrosis.

Experts discuss the clinical implications of the MAJIC-PV trial.

Panel experts talk about when to use cytoreductive therapy and which factors influence their treatment selection as well as reviewing how patients with PV are monitored.

Faculty discuss the treatment goals for patients diagnosed with polycythemia vera and review treatment options for managing PV.

Expert oncologists discuss the REVEAL study and provide their thoughts on these data and the impact in clinical practice.

Experts discuss the optimal strategy for NGS testing, which alterations to test for and how to assess for risk when diagnosing and managing patients with polycythemia vera (PV).

Andrew Kuykendall, MD, discusses the efficacy of pelabresib plus ruxolitinib in patients with JAK inhibitor–naive myelofibrosis.