Claire Harrison, MD, FRCP, FRCPath, professor of myeloproliferative neoplasms, clinical director, NHS Guy’s and St Thomas’ NHS Foundation Trust, discusses current unmet needs in myelofibrosis.

Several unmet needs remain in the treatment of patients with myelofibrosis, including the lack of treatments available for low-risk patients who are diagnosed with myelofibrosis, a cancer that shortens their life expectancy, Harrison says. Moreover, available treatments are not wholly effective for patients with myelofibrosis and, aside from bone marrow transplants, do not modify the disease, Harrison explain. Moreover, these limited treatment options are associated with shortcomings and the median duration of response for many of the treatments is 3 years, Harrison adds.

Although fedratinib (Inrebic) is FDA approved for use a second-line therapy for patients with myelofibrosis, patients will likely experience disease progression while on the agent, Harrison says. 

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Claire Harrison, MD, FRCP, FRCPath, discusses current unmet needs in myelofibrosis. 

Dr. Harrison on Unmet Needs in Myelofibrosis 

Claire Harrison, MD, FRCP, FRCPath, professor of myeloproliferative neoplasms, clinical director, NHS Guy’s and St Thomas’ NHS Foundation Trust, discusses the current state of treatment in myelofibrosis.

Treatment selection for patients with myelofibrosis is largely dictated by disease stage and patient-specific clinical features, Harrison explains. For example, a low-risk patient without prominent disease features is best suited for active surveillance. However, therapeutic strategies, such as interferon, are being evaluated for these patients because in other diseases, such as breast cancer, active surveillance would never be recommended for patients with early-stage disease, Harrison explains.

For patients with higher-risk myelofibrosis, stem cell transplant can be considered, Harrison says. Patients who are ineligible for transplant are treated based on their disease-related symptoms with transfusion or erythropoiesis-stimulating agents for anemia or JAK inhibitors for splenomegaly, Harrison concludes.

Claire Harrison, MD, FRCP, FRCPath, discusses the current state of treatment in myelofibrosis.  



Dr. Harrison on the Current State of Treatment in Myelofibrosis 

Claire Harrison, MD, deputy clinical director of Cancer and Hematology, Guy's and St. Thomas' NHS, discusses 5-year follow-up data examining ruxolitinib in patients with myelofibrosis.

The phase III COMFORT-II study is known as one of the clinical trials that led to ruxolitinib’s FDA approval, Harrison explains. Myelofibrosis is a malignancy associated with splenomegaly, significant constitutional symptoms, and a reduction in life expectancy. Initial data released from the study demonstrated that, upon treatment with ruxolitinib, patients had a significant improvement in quality of life and a reduction in spleen size. Follow-up data showed that the agent also prolonged survival in patients.

The 5-year follow-up results of the study represents a high volume of patient data for myelofibrosis, Harrison says. The long-term data showed a reduction in spleen volume in 35% of patients. Moreover, reductions in JAK2 V617F allele burden occurred in 80% to 100% of patients, she adds.

View more from the 2015 ASH Annual Meeting

Claire Harrison, MD

Articles

Dr. Harrison on Unmet Needs in Myelofibrosis

Dr. Harrison on the Current State of Treatment in Myelofibrosis

Dr. Harrison on 5-Year Follow-Up Data on Ruxolitinib in Patients With Myelofibrosis