The content of this booklet was taken from CancerCare’s two-part Connect Education Workshop 2018 ASCO Highlights series, during which the following leading experts presented:
Al B. Benson, III, MD, FACP, FASCO(Colorectal Cancer), Professor of Medicine, Associate Director for Cooperative Groups, Robert H. Lurie Comprehensive Cancer Center, Northwestern University
Gregory A. Daniels, MD, PhD(Melanoma), Associate Clinical Professor of Medicine, University of California San Diego, Rebecca and John Moores Cancer Center
Keith D. Eaton, MD, PhD(Clinical Trials), Clinical Director, Thoracic, Head and Neck Oncology, Medical Director, Infusion and Pharmacy, Medical Director, Quality, Safety and Value, Seattle Cancer Care Alliance, Associate Member, Fred Hutchinson Cancer Research Center, Associate Professor of Medicine, University of Washington School of Medicine
Julie R. Gralow, MD(Breast Cancer), Jill Bennett Endowed Professor of Breast Cancer, Director, Breast Medical Oncology, University of Washington School of Medicine, Seattle Cancer Care Alliance
Fabio Iwamoto, MD(Brain Cancer), Assistant Professor of Neurology, Deputy Director, Division of Neuro-Oncology, Department of Neurology, Columbia University Irving Medical Center
Mark G. Kris, MD(Lung Cancer), Attending Physician, Thoracic Oncology Service, The William and Joy Ruane Chair in Thoracic Oncology, Memorial Sloan Kettering Cancer Center, Professor of Medicine, Weill Cornell Medical College
John P. Leonard, MD(Lymphoma), Richard T. Silver Distinguished Professor of Hematology and Medical Oncology, Associate Dean for Clinical Research, Weill Cornell Medical College, Vice Chairman for Clinical Research, Weill Department of Medicine, Associate Director of Clinical Trials, Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine, Attending Physician, Chief Lymphoma Service, New York-Presbyterian, Director of the Joint Clinical Trials Office, Weill Cornell Medicine and New York-Presbyterian
Michael J. Mauro, MD(Leukemia), Leader, Myeloproliferative Neoplasms Program, Clinical Director, Leukemia Service, Member, Memorial Sloan Kettering Cancer Center, Professor of Medicine, Weill Cornell Medical College
Eileen M. O'Reilly, MD(Pancreatic Cancer), Associate Director, David M. Rubenstein Center for Pancreatic Cancer, Attending Physician, Member, Memorial Sloan Kettering Cancer Center, Associate Professor, Weill Cornell Medical College
Priscilla Merriam, MD(Sarcoma), Physician, Medical Oncology, Sarcoma and Bone Cancer Treatment Center, Dana-Farber Cancer Institute, Instructor in Medicine, Harvard Medical School
Ruben A. Mesa, MD, FACP(Myeloproliferative Neoplasms), Director, UT Health San Antonio Cancer Center, Mays Family Foundation Distinguished University Presidential Chair, Professor of Medicine with Tenure
Krzysztof Misiukiewicz, MD, MSCR (Oral, Head, and Neck Cancers), Associate Professor of Medicine, Hematology and Medical Oncology, Assistant Professor, Otolaryngology, Icahn School of Medicine at Mt. Sinai, Mount Sinai Hospital
Carolyn D. Runowicz, MD (Ovarian Cancer), Executive Associate Dean for Academic Affairs, Professor, Department of Obstetrics and Gynecology, Herbert Wertheim College of Medicine, Florida International University
Susan Slovin, MD, PhD(Prostate Cancer), Attending Physician, Genitourinary Oncology Service, Sidney Kimmel Center for Prostate and Urologic Diseases, Memorial Sloan Kettering Cancer Center, Professor of Medicine, Weill College of Cornell University
Researchers reported a number of important findings in the treatment of myeloproliferative neoplasms (MPNs) at the 2018 Annual Meeting of the American Society of Clinical Oncology:
Retrospective study showed increased risk of aggressive lymphomas when patients with MPNs treated with JAK inhibitors
A retrospective study showed that a small but significant proportion of patients with myeloproliferative neoplasms developed aggressive lymphomas during treatment with a Janus kinase (JAK) inhibitor. In a study of 929 patients, 9.7 percent of those treated with JAK1/2 inhibitors developed aggressive B-cell lymphomas compared to 0.54 percent of patients treated with other drugs.
What Patients Need to Know
Researchers determined that patients most at risk for developing an aggressive lymphoma had a pre-existing B-cell clone that underwent transformation during treatment with JAK inhibitors; they suggest that people with myelofibrosis be tested for this B-cell clone before undergoing treatment with JAK inhibitors.
Experimental drug being evaluated as treatment for anemia in MPN-associated myelofibrosis
Anemia is a significant complication of MPN-associated myelofibrosis, with few effective therapies other than red blood cell transfusions. A phase II multicenter global trial is evaluating the experimental drug luspatercept as a potential treatment option for anemia in these patients.
What Patients Need to Know
The trial will evaluate a number of endpoints, including the safety of luspatercept and the improvement in the anemia both short-term and long-term. A determination will also be made whether a randomized phase III trial should be conducted.
JAK1/2 inhibitors being studied in the context of stem cell transplantation for patients with myelofibrosis
Since its FDA approval in 2011, the JAK ½ inhibitor ruxolitinib has become a routine treatment for MPN-associated myelofibrosis. However, allogeneic hematopoietic stem cell transplant remains the only treatment with the potential to treat myelofibrosis. (In an allogeneic hematopoietic stem cell transplant, the person receives blood-forming stem cells from a genetically similar donor.)
Ongoing research is being conducted on the impact JAK ½ inhibitors could have on the timing of allogeneic hematopoietic stem cell transplant and their effect on post-transplantation outcomes.
What Patients Need to Know
Researchers say the identification of guidelines for the use of JAK1/2 inhibitors in the context of transplantation may lead to new treatment strategies for patients with myelofibrosis.