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JAK inhibitors for MF: Individualizing treatment selection
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Four JAKi are currently approved for the treatment of patients with MF in Europe and the USA; ruxolitinib, fedratinib, pacritinib, and momelotinib. Each JAKi has distinct properties which may be suitable for different patient profiles. A recent publication in Blood by Masarova and Chifotides discusses the optimization of JAKi treatment selection for patients with MF.1
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| Key learnings |
| For patients with MF and adequate platelet counts, ruxolitinib is the preferred first-line treatment due to its robust efficacy; it can control splenomegaly and constitutional symptoms and extend OS. |
| Fedratinib is typically used in second-line settings. It has demonstrated strong symptom control; however, there is a higher risk of GI side effects. |
| Pacritinib and momelotinib are less myelosuppressive and crucial for patients with MF and severe thrombocytopenia or anemia. Momelotinib is uniquely beneficial as it reduces transfusion dependence, which is linked to improved survival. |
| Individualizing JAKi therapy based on cytopenia severity and dominant symptoms, such as splenomegaly or anemia, can optimize patient outcomes. |
| Expanding treatment options enables more personalized and effective management strategies for MF to improve survival and QoL. |
Abbreviations: GI, gastrointestinal; JAKi, Janus kinase inhibitor; MF, myelofibrosis; MPN, myeloproliferative neoplasm; OS, overall survival; QoL, quality of life.
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