JAK2 Inhibitor Selection for Primary Myelofibrosis


Harry P. Erba, MD, PhD: Srdan, how do you choose in first-line setting between ruxolitinib and fedratinib? Fedratinib is a pure JAK2 inhibitor, so is it effective at controlling symptoms like ruxolitinib?

Srdan Verstovsek, MD, PhD: On the results from the JAKARTA study, the results appear to be similar, although we did not compare 1 to the other in a randomized way. The results appear to be similar in terms of controlling the spleen and the symptoms between the ruxolitinib and the fedratinib.

There are some differences, as we just explained, in the toxicity profile, but the most attractive part for fedratinib for me is what Ruben has said. The results of JAKARTA2 study, this is the second-line study, certainly indicate its potential role in the setting where we don’t have options at all.

The reanalysis of that study, which was an open-label phase 2 study published 3 months ago, showed that about 50% of the patients will officially achieve the response, which is 35% volumetric reduction. Regardless of that percentage, it is valuable in many patients for whom we need to control the symptoms and signs after ruxolitinib. That is where I see a major role; it has a minor role in the frontline setting and a major role in the second-line setting.

Transcript Edited for Clarity

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