Patients with myelofibrosis can experience debilitating symptoms that negatively impact their quality of life. In the phase 3 JAKARTA trial, a team of researchers led by Ruben Mesa, MD, the Director of MD Anderson Cancer Center at the University of Texas, San Antonio, found that fedratinib, an oral JAK2 inhibitor, decreased symptom severity and markedly improved quality of life in patients with intermediate- or high-risk primary or secondary myelofibrosis. Dr. Mesa presented the results of the trial at the American Society of Hematology (ASH) Annual Meeting on Monday, December 9th. In this interview with i3 Health, Dr. Mesa discusses the symptom relief and significant improvements in quality of life that fedratinib has to offer for patients with myelofibrosis.
In what ways does myelofibrosis negatively affect patient quality of life?
Ruben Mesa, MD: Myelofibrosis affects patients with difficult spleen-related symptoms, such as early satiety, pain, and discomfort; constitutional symptoms, such as fatigue, cachexia, and night sweats; and cytopenia-related symptoms, such as dyspnea, bruising, and bleeding risk. Patients can also experience pruritus.
Can you comment on the significance of your findings?
Dr. Mesa: Fedratinib is now only the second FDA approved medication and JAK inhibitor for patients with myelofibrosis. In our trial, fedratinib relieved symptoms and improved quality of life in both ruxolitinib-naive and previously treated patients.
How does fedratinib compare with other treatments for intermediate- or high-risk primary or secondary myelofibrosis?
Dr. Mesa: Of the available agents, fedratinib and ruxolitinib are currently the only treatments that show significant activity in myelofibrosis.While there is no head-to-head data, studies of front-line fedratinib show that it is comparable to ruxolitinib, and it clearly has benefit in the second-line setting.
Do you have any words of advice for community oncologists and hematologists treating patients with intermediate- or high-risk primary or secondary myelofibrosis?
Dr. Mesa: Fedratinib is now approved for patients with intermediate- or high-risk myelofibrosis, and it is a consideration for those who are JAK-naive. However, fedratinib should be especially considered for patients with prior ruxolitinib failure or those who are currently on ruxolitinib with a suboptimal response.
About Dr. Mesa
Ruben Mesa, MD, is the Director of the MD Anderson Cancer Center at the University of Texas, San Antonio. He is also the former Deputy Director of the Mayo Clinic Cancer Center in Arizona. Dr. Mesa specializes in the treatment of myeloproliferative neoplasms, including polycythemia vera, essential thrombocythemia, and myelofibrosis. He has authored over 800 clinical publications and serves as the Editor-in-Chief of Current Hematology Malignancy Reports. Dr. Mesa is an international expert in the treatment of myeloproliferative neoplasms, and his research focuses on the development of novel therapeutics to optimize treatment and improve quality of life in patients with these malignancies.
For More Information
Mesa RA, Schaap N, Vannucchi AM, et al (2019). Health-related quality of life (HRQoL) in patients with myelofibrosis treated with fedratinib, an oral, selective inhibitor of Janus Kinase 2 (JAK2), in the randomized, placebo-controlled, phase III JAKARTA study. 61st American Society of Hematology Annual Meeting & Exposition. Abstract 704.
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily represent those of i3 Health.