Novel therapeutics in myeloproliferative neoplasms

Abstract Hyperactive signaling of the Janus-Associated Kinase/Signal Transducers and Activators of Transcription (JAK/STAT) pathway is central to the pathogenesis of Philadelphia-chromosome-negative myeloproliferative neoplasms (MPN), i.e., polycythemia vera (PV), essential thrombocythemia (ET), and...

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Main Authors: Sangeetha Venugopal, John Mascarenhas
Format: Article
Language:English
Published: BMC 2020-12-01
Series:Journal of Hematology & Oncology
Subjects:
Online Access:https://doi.org/10.1186/s13045-020-00995-y
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author Sangeetha Venugopal
John Mascarenhas
author_facet Sangeetha Venugopal
John Mascarenhas
author_sort Sangeetha Venugopal
collection DOAJ
description Abstract Hyperactive signaling of the Janus-Associated Kinase/Signal Transducers and Activators of Transcription (JAK/STAT) pathway is central to the pathogenesis of Philadelphia-chromosome-negative myeloproliferative neoplasms (MPN), i.e., polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) which are characterized by inherent biological and clinical heterogeneity. Patients with MPNs suffer from substantial symptom burden and curtailed longevity due to thrombohemorrhagic complications or progression to myelofibrosis or acute myeloid leukemia. Therefore, the management strategies focus on thrombosis risk mitigation in PV/ET, alleviation of symptom burden and improvement in cytopenias and red blood cell transfusion requirements, and disease course alteration in PMF. The United States Food and Drug Administration’s (USFDA) approval of two JAK inhibitors (ruxolitinib, fedratinib) has transformed the therapeutic landscape of MPNs in assuaging the need for frequent therapeutic phlebotomy (PV) and reduction in spleen and symptom burden (PV and PMF). Despite improving biological understanding of these complex clonal hematopoietic stem/progenitor cell neoplasms, none of the currently available therapies appear to modify the proclivity of the disease per se, thereby remaining an urgent unmet clinical need and an ongoing area of intense clinical investigation. This review will highlight the evolving targeted therapeutic agents that are in early- and late-stage MPN clinical development.
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spelling doaj.art-db7a39e6b6eb4f27a4d7ad8a4b83c3d62022-12-21T23:44:09ZengBMCJournal of Hematology & Oncology1756-87222020-12-0113111310.1186/s13045-020-00995-yNovel therapeutics in myeloproliferative neoplasmsSangeetha Venugopal0John Mascarenhas1Department of Leukemia, MD Anderson Cancer Center, University of TexasDivision of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L Levy PlaceAbstract Hyperactive signaling of the Janus-Associated Kinase/Signal Transducers and Activators of Transcription (JAK/STAT) pathway is central to the pathogenesis of Philadelphia-chromosome-negative myeloproliferative neoplasms (MPN), i.e., polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) which are characterized by inherent biological and clinical heterogeneity. Patients with MPNs suffer from substantial symptom burden and curtailed longevity due to thrombohemorrhagic complications or progression to myelofibrosis or acute myeloid leukemia. Therefore, the management strategies focus on thrombosis risk mitigation in PV/ET, alleviation of symptom burden and improvement in cytopenias and red blood cell transfusion requirements, and disease course alteration in PMF. The United States Food and Drug Administration’s (USFDA) approval of two JAK inhibitors (ruxolitinib, fedratinib) has transformed the therapeutic landscape of MPNs in assuaging the need for frequent therapeutic phlebotomy (PV) and reduction in spleen and symptom burden (PV and PMF). Despite improving biological understanding of these complex clonal hematopoietic stem/progenitor cell neoplasms, none of the currently available therapies appear to modify the proclivity of the disease per se, thereby remaining an urgent unmet clinical need and an ongoing area of intense clinical investigation. This review will highlight the evolving targeted therapeutic agents that are in early- and late-stage MPN clinical development.https://doi.org/10.1186/s13045-020-00995-yMFETPVJAK-STATCALRRuxolitinib
spellingShingle Sangeetha Venugopal
John Mascarenhas
Novel therapeutics in myeloproliferative neoplasms
Journal of Hematology & Oncology
MF
ET
PV
JAK-STAT
CALR
Ruxolitinib
title Novel therapeutics in myeloproliferative neoplasms
title_full Novel therapeutics in myeloproliferative neoplasms
title_fullStr Novel therapeutics in myeloproliferative neoplasms
title_full_unstemmed Novel therapeutics in myeloproliferative neoplasms
title_short Novel therapeutics in myeloproliferative neoplasms
title_sort novel therapeutics in myeloproliferative neoplasms
topic MF
ET
PV
JAK-STAT
CALR
Ruxolitinib
url https://doi.org/10.1186/s13045-020-00995-y
work_keys_str_mv AT sangeethavenugopal noveltherapeuticsinmyeloproliferativeneoplasms
AT johnmascarenhas noveltherapeuticsinmyeloproliferativeneoplasms