Dr. Verstovsek on Future Research Efforts in MPNs

Srdan Verstovsek, MD, PhD, the United Energy Resources, Inc. Professor of Medicine, director of the Hanns A. Pielenz Clinical Research Center for Myeloproliferative Neoplasms​, and chief of the Section for Myeloproliferative Neoplasms in the Department of Leukemia of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses future research efforts for patients with myeloproliferative neoplasms (MPNs).

The field of MPNs is relatively simple in terms of selecting patients for treatment, according to Verstovsek. JAK inhibitors are typically utilized in the frontline setting, followed by the second line, with a notable focus on alleviating splenic symptoms. Efforts are shifting to focus on anemia, with luspatercept (Reblozyl) making a difference in the first line setting, and momelotinib (formerly GS-0387) having been developed for the second-line setting.

While lines of treatment have been established, patients are beginning to be stratified based on their clinical needs, Verstovsek explains. In the second-line setting, for example, fedratinib (Inrebic) can be used patients who are experiencing splenic symptoms. However, patients in the same setting with anemia may receive momelotinib, while low platelets can be treated with pacritinib.

The separation is currently underway, in addition to including add-on approaches. However, patient characteristics are largely responsible for guiding drug development, not the simplistic view of first- and second-line treatments, Verstovsek concludes.