Dr. Mesa on Treatment Advancements Made in MPNs

Ruben A. Mesa, MD, director, UT Health San Antonio MD Anderson Cancer Center, discusses advancements made in the treatment of patients with myeloproliferative neoplasms (MPNs).

It is an exciting time in terms of therapeutic progress made in MPNs, says Mesa. First, there have been further updates on the important role of long-acting interferons in the treatment of patients with essential thrombocythemia or polycythemia vera. Long-acting interferons are having an impact on outcomes and are possibly superior to the use of hydroxyurea, in both the first- and second-line settings. Data presented at the 2019 ASH Annual Meeting with long-acting interferons showed both thrombosis-free survival as well as a potential molecular impact in this space, says Mesa.

In myelofibrosis, a very robust set of therapies are being developed, adds Mesa. For example, investigators are examining a group of JAK inhibitors that are expected to complement each other in terms of their activity. Additionally, novel combinations comprised of drugs with different mechanisms of action, such as BET, TGF-β, and LSD1 inhibition, are also under exploration. New drugs are also in development for use as single agents, says Mesa.

We’re seeing parallel advances in the treatment of patients with myelodysplastic syndromes with oral hypomethylating agents; these agents will certainly have a benefit for patients with advanced MPNs, as well, concludes Mesa.