A roundtable discussion on anemia management in myeloproliferative neoplasms, featuring moderator
John Mascarenhas, MD, Mount Sinai; Andrew Kuykendall, MD, Moffitt Cancer Center; and Gabriela Hobbs, MD, Massachusetts General Research Institute.
The following is an unedited transcript:
So maybe let’s go back and focus on luspatercept a bit because I think that’s an interesting drug. You know, we do have phase two data from, the early studies at least, showing that it’s got responses about 30% and maybe even 50% transfusion reduction, about 50%. So it’s got some clinical activity. And at least my perception from, from clinical trial use and even commercial use off label pretty well tolerated drug.
I just want to get a sense what you guys feel about the addition of luspatercept. And where do you see it? If one was to use it again off label, you know, until the independent study reads out, where where does it use best?
I think based on the, the phase two data that we have available using in combination with ruxolitinib is where it makes the most sense, and it’s definitely where I’ve used it the most. Although. And then I have seen some really nice responses in, in hemoglobin and generally pretty well tolerated. But I have had some patients that are just anemic that have not done well on, you know, Dan is already assay.
Where I’ve used it was better by itself, but that’s again smaller numbers and and more and.
And it was effective and.
It was effective. Yeah.
Yeah. So with luspatercept, something I think, this this is an agent that I think is interesting because I think from the phase two data, right. When you’re talking about taking from someone from truly transfusion dependent to transfusion independent, that’s a big jump, right. And so there’s probably an additional percentage of patients. Right. That was around 28% or 30%.
Right. Was the response right there. So there’s probably an additional 1,520% or so that are having benefit from the agent that maybe not measured by that kind of stark, improvement in transfusion requirements. And so, you know, I think when you go back and I think what’s, you know, the question is what’s the value of doing that? Right?
What’s the value of making someone not need transfusions. Obviously, you know, lifestyle. Right. Like it’s going to be nice for them not to be tied to the health care system. But you think about something like the RR6, right, where you’re talking about that person who’s having growth of the spleen, right, who’s who’s maybe requiring lower dose of ruxolitinib, who’s requiring transfusion.
Can you flip that like risk model if you’re able to make someone require less transfusions and make them and allow them to be on a higher dose of Ruxolitinib. I think that’s something we haven’t looked at there.
But yeah, we definitely don’t have data to know if you are able to get luspatercept and improve the hemoglobin, can you really increase the dose of ruxolitinib to like you said, flip the RR6.
