Dr. Rampal on Selecting Among Available JAK Inhibitors in Myelofibrosis

Raajit K. Rampal, MD, PhD, hematologic oncologist, Memorial Sloan Kettering Cancer Center, discusses considerations for selecting among the JAK inhibitors ruxolitinib (Jakafi) and fedratinib (Inrebic) in the treatment of patients with myelofibrosis.

Although there is no specific reason to utilize 1 drug over the other, there are select cases where 1 agent could be more beneficial for patients, according to Rampal. For example, the dosing of ruxolitinib is based on platelet counts, and the dose a patient receives will be lowered if they have a platelet count ranging from 50,000 to 100,000, Rampal says. With fedratinib, the same dose can be used irrespective of a patient’s platelet count. As such, in select patients, treatment with fedratinib may be more beneficial, Rampal explains.

Additionally, it is important to consider the potential adverse effects [AEs] of these agents, such as the gastrointestinal AEs observed with fedratinib, prior to treatment, Rampal notes. Discussing potential AEs with patients is an important aspect of choosing the optimal therapeutic option for each patient, Rampal concludes.