Dr. Mesa on Investigative Therapies in Myelofibrosis

Ruben Mesa, MD, the director of the Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, discusses therapies under investigation in myelofibrosis.

Several therapies are currently under investigation in the second-line setting to be used alone or in combination, says Mesa. There is some interest in examining the use of a BET inhibitor to treat patients with myelofibrosis, which is working on the pathways at a variety of different levels and is particularly helpful for patients with the ASXL1 mutation. Some data from the phase II MANIFEST study demonstrated that BET inhibitors, when used alone or in combination, could have positive effects in patients with myelofibrosis, says Mesa. Some research is even examining the use of these agents in combination with JAK inhibition in the frontline setting.

Additionally, there are data looking at the addition of venetoclax (Venclexta) to ruxolitinib (Jakafi) in patients who are experiencing suboptimal response. Promising data from a phase II study showed that a LSD1 inhibitor had a benefit in the second-line setting. Furthermore, data showed a benefit with luspatercept in improving anemia in these patients, according to Mesa.

In collaboration with the National Cancer Institute—funded MPN Research Consortium, Mesa participates in a variety of studies being conducted in the myelofibrosis setting. For example, a phase I study is being done on AVID200 looking at TGF-ß and there is hope that it will be active, Mesa concludes.