Mesa Gives an Overview of Myelofibrosis in 2021

At ASH 2021, CancerNetwork® spoke with Ruben Mesa, MD, of UT Health San Antonio MD Anderson Cancer Center, about key takeaways learned in the treatment of myelofibrosis during 2021.

Much of what we have focused on is the care of the patients in the active chronic phase of the disease. In the future, we’re going to have more efforts to complement this for earlier disease to help it from getting to that progressive point. Will that be with interferon or some other approach? Is that vaccine therapy against calreticulin, or is it some other paternal preventative strategy? I certainly hope so. Again, we do know some patients are in earlier disease. [For them], how do we help avoid progression in the disease?

On the other end of the spectrum, our patients with accelerated or blast phase disease are moving more toward acute leukemia. That has been a much more difficult group of patients to treat. The current standard is a JAK2 inhibitor with a hypomethylating agent. That’s been helpful. It certainly is reasonable and you certainly can consider that, but it’s far from as nearly efficacious as we wish. We’ll be seeing more about the evolving therapies in acute leukemia, and how they relate to this group. Some of the scientific discoveries that were reported at this year’s ASH meeting regarding TP53and inflammation [as well as] other molecular markers will likely be very important in trying to understand how we treat people with the most aggressive and life-threatening disease. I’m hoping that we can really get to a point where we have some kind of [treatment] across the spectrum and that we can hopefully decrease the number of people who end up in that most difficult-to-treat group of accelerated and blast phase [disease].