Hematologic Oncology | Ruben A Mesa, MD

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By Dr Neil Love. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

Myeloproliferative Neoplasms Update — Part 1: Our interview with Dr Mesa highlights the following topics and cases from his practice:

  • Molecular pathogenesis of myeloproliferative neoplasms (MPNs) (00:00)
  • Cytokine activation and its association with the distinct symptomatology of MPNs (3:42)
  • Targeting the JAK-STAT pathway in myelofibrosis (MF) and polycythemia vera (PV) (5:19)
  • Case:A 66-year-old man with symptomatic primary MF with a CALR mutation receives ruxolitinib (9:05)
  • Clinical parameters to evaluate when considering treatment with ruxolitinib (11:23)
  • Discussing the complexities of allogeneic transplant with patients considering this intervention (16:05)
  • Clinical outcomes and complication rates for younger versus older patients undergoing transplant (16:46)
  • Counseling patients regarding the efficacy and side-effect profile of ruxolitinib (20:41)
  • Symptom improvement with ruxolitinib; dosing for patients with MF (24:14)
  • Management of anemia associated with ruxolitinib treatment (26:27)
  • Approach to dosing ruxolitinib for patients with MF and cytopenias (29:58)
  • Consideration of ruxolitinib treatment holidays and therapy reinitiation for patients with increased splenomegaly (32:22)
  • Treatment options for patients with MF and disease progression on ruxolitinib (36:20)
  • Clonal evolution and outcomes in MF after ruxolitinib discontinuation (38:53)
  • Therapeutic options for patients who experience disease progression on ruxolitinib (41:06)
  • Activity, tolerability and ongoing investigation of novel JAK inhibitors pacritinib, momelotinib and fedratinib in MF (44:36)
  • FDA clinical hold on fedratinib due to possible occurrences of Wernicke encephalopathy in patients on the JAKARTA-1 trial and recent lift of the hold (47:46)
  • Ongoing investigation of fedratinib in MF (48:56)
  • Clinical experience with pacritinib, momelotinib and fedratinib (52:46)
  • Toward identifying molecular predictors of response to pacritinib, momelotinib and fedratinib (53:59)
  • Case: A 64-year-old woman with ruxolitinib-refractory MF receives fedratinib on the Phase II JAKARTA-2 trial (55:51)
  • Therapeutic approach to MF that progresses to acute myeloid leukemia (59:26)
  • Investigation of the novel Bcl-2 inhibitor navitoclax in combination with ruxolitinib for patients with MF (1:2:42)
  • Clinical manifestations and treatment of PV (1:3:12)
  • Case: A 56-year-old woman with high-risk PV and an inadequate response to hydroxyurea receives ruxolitinib (1:5:53)
  • Risk stratification and treatment for patients with essential thrombocythemia (ET) (1:8:26)

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