Dr. Prithviraj Bose

Dr. Prithviraj Bose discussed the current treatment landscape for myeloproliferative neoplasms, a group of rare blood cancers; he focused on myelofibrosis.

Understanding Current Treatment for Myelofibrosis

Dr. Prithviraj Bose, a professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center in Houston, participated in an interview with CURE to provide insight into the current treatment landscape for patients with myeloproliferative neoplasms, a group of rare blood cancers. In particular, he focused on myelofibrosis.

“Myelofibrosis therapy today is still limited to the four JAK inhibitors,” he noted.

therapies include Jakafi (ruxolitinib), Inrebic (fedratinib), Vonjo (pacritinib), and Ojjaara (momelotinib).

patients with myelofibrosis can work with their care team

 to understand their treatment options in another conversation with CURE.

Can you walk us through the current treatment landscape for myelofibrosis, and how you decide which therapies are best suited for individual patients?

Myelofibrosis therapy today is still limited to the four JAK inhibitors. However, we do use some unapproved therapies in [certain] situations. For example, interferon can be used for very early disease when the spleen is not enlarged, symptoms are not prominent and there are no cytopenias, with the hope of disease modification.

There are some patients, not too many, who present with just anemia as their main [issue]. In that case, we can use therapies directed purely at anemia. But most patients will eventually need JAK inhibitors because they tend to have some degree of splenomegaly and symptoms.

That is where we really need to be aware of the strengths and weaknesses of the four approved drugs: Jakafi, Inrebic, Vonjo and Ojjaara. It is important to really evaluate the data [of these agents] and try to tailor it [for each individual patient]. For example, with significant anemia, I would typically reach for Ojjaara. Jakafi, however, has a survival advantage, so sometimes you might choose Jakafi and counteract the anemia with another therapy.

A lot of factors go into this decision-making, but the most important thing is to target what the patient needs the most.

Transcript has been edited for clarity and conciseness.

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Dr. Prithviraj Bose discusses how patients with myelofibrosis can better understand their options and access the most up-to-date advancements in care.

Expert Highlights Importance of Understanding Myelofibrosis Treatments 

Choosing the right treatment path for patients with myelofibrosis can feel overwhelming, especially as new therapies and clinical trials continue to expand, according to Dr. Prithviraj Bose.

He goes on to say that patients benefit most when they partner closely with their care teams and, whenever possible, consult with a myeloproliferative neoplasm (MPN) specialist. To talk more about navigating treatment decisions and the importance of specialized care, Bose sat down for an interview with CURE. During the discussion, he explained how patients can better understand their options and access the most up-to-date advancements in care.

Bose currently serves as a professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center in Houston.

With new therapies and combinations being studied, how can patients with myelofibrosis work with their care team to understand which treatment options are best suited for their individual situation?

MPNs are still rare enough that patients are best advised to see an MPN specialist. While they can certainly work with their local hematologist, it's a good idea, in general, given that these are rare conditions, to see someone who focuses on MPNs. They can give the patient a more nuanced understanding of the different treatment choices we have today, as well as the profusion of clinical trials.

The trials can be a dizzying maze. There are so many trials in so many settings; there are so many designs. I often have patients who have read up on them but who have not perhaps been able to appreciate some key differences in the design, which I don't blame them for, as this is not what they do.

Overall, I think it's really important that patients try to seek care from someone who focuses on this area and is well-versed with everything that's going on.

Dr. Prithviraj Bose

Understanding Current Treatment for Myelofibrosis

Expert Highlights Importance of Understanding Myelofibrosis Treatments

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