Mesa Considers Next Steps With Pacritinib in Myelofibrosis


Ruben Mesa, MD, spoke about why pacritinib in the treatment of myelofibrosis is beneficial.

Ruben Mesa, MD, executive director of Mays Cancer Center, home of the UT Health San Antonio MD Anderson Cancer Center, spoke with CancerNetwork® about future research involving pacritinib (Vonjo) following its accelerated approval in intermediate- or high-risk primary or secondary myelofibrosis with severe thrombocytopenia. Mesa served as lead investigator on the PERSIST-1 trial (NCT01773187), which examined pacritinib in this setting.


We now have mature data in terms of what monotherapy with pacritinib looks like in the front-line or second-line setting, particularly for individuals with marked thrombocytopenia. Combination therapies are intriguing, and there are many interesting agents, almost 10 that have a different mechanism of action distinct from JAK2, that are in development. Many of them can cause thrombocytopenia themselves.

The approval of pacritinib is a significant advance for patients with myelofibrosis. It allows us to create a new group of individuals. Importantly, it also shows that this is a disease where multiple therapies are needed. There is a range of different phenotypes of the disease and many new mechanisms of action are being identified, even with IRAK-1 as an additional important new target. I’m excited to see this advance and excited to see our patients with myelofibrosis [given] more options.


Mesa RA, Vannucchi AM, Mead A, et al. Pacritinib versus best available therapy for the treatment of myelofibrosis irrespective of baseline cytopenias (PERSIST-1): an international, randomised, phase 3 trial. Lancet Haematol. 2017;4(5):e225-e236. doi:10.1016/S2352-3026(17)30027-3

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Ruben Mesa, MD, spoke about the approval of pacritinib and its importance for the treatment of myelofibrosis.