Wow, the MPN field is fascinating right now! So many new drugs and combinations are being tested for patients with myeloproliferative malignancies. Let us tell you about some of the most promising ones in phase III testing.
One is Ruxolitinib, a JAK inhibitor already approved for myelofibrosis and polycythemia vera. Ruxolitinib is being combined with different drugs to see if they can enhance their effects. For example, pelabresib is a BET inhibitor that can modulate gene expression and inflammation. Navitoclax is a BCL-2 inhibitor that can induce apoptosis of malignant cells. Both drugs synergized with ruxolitinib in phase II studies, leading to improved spleen shrinkage, bone marrow fibrosis, and reduced driver mutation and cytokines.
We look forward to the results of phase III trials for these combinations.
Another combination being tested is ruxolitinib with luspatercept, an erythroid maturation agent that can stimulate red blood cell production. Luspatercept is already approved for MDS and may help patients with anaemia. The INDEPENDENCE trial compares ruxolitinib plus luspatercept versus ruxolitinib plus placebo in patients requiring transfusions. The objective is to verify if luspatercept can reduce the transfusion load and improve the quality of life of these patients.
Luspatercept is also being studied as a single agent in a phase III trial called MEDALIST-2, enrolling myelofibrosis patients with anemia and low or intermediate-1-risk disease. The primary endpoint is transfusion independence, and secondary endpoints include reduced spleen volume, improvement in symptoms, and survival.
These are just some of the exciting developments in the MPN field. Some many other drugs and combinations are being explored in clinical trials, and we expect to see more positive results soon.
Stay tuned for the latest news!
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