Dr. Snyder Discusses Ongoing Research in Myelofibrosis

David S. Snyder, MD, associate chair, Department of Hematology and Hematopoietic Cell Transplantation, professor, Hematology and Hematopoietic Cell Transplantation, and hematologist/oncologist, City of Hope, discusses ongoing research in myelofibrosis.

Momelotinib is one of the JAK inhibitors under investigation in myelofibrosis. Unlike ruxolitinib (Jakafi), momelotinib can preserve hemoglobin, says Snyder. Although trials showed conflicting results, it’s under continued evaluation.

Pacritinib is another JAK inhibitor that seems to be platelet-sparing, which is one of the main limiting factors of using ruxolitinib. As such, this agent may be useful in patients with platelet counts below 50,000. If pacritinib moves forward in development, it could extend the utility of JAK inhibition in myelofibrosis. A phase II trial with the agent has just completed and a phase III trial is planned, which is geared toward patients who have very low platelet counts.

The telomerase inhibitor, imetelstat is also being evaluated. There was initial excitement with the agent in early studies, but it can be difficult to manage because of myelosuppression, says Snyder. Nonetheless, it is still being evaluated in clinical trials, he concludes.