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 the RR6 model, I think is really important when we’re evaluating kind of the modern age of patients where most patients are treated with ruxolitinib . And I think it’s really important to kind of understand those details when we think about, you know, how can these anemia acting agents be useful in practice? So the RO6 model was really developed on ruxolitinib-treated patients.
And the idea was like, can we predict for the patients that are not going to do as well? And there’s three main factors that came up. Three main variables. And you know, those those variables. Where were you requiring transfusions at any time during treatment. And the first 24 weeks where you on a suboptimal dose defined as less than 20mg twice daily.
And did you have a lack of a spleen response, which often is tied to, to suboptimal doses as well. And so one of the things that comes into question there is if you had those factors, so lack of a spleen response, anemia requiring transfusions, lower dose that would predict that you’re not going to do as well, with, with ruxolitnib therapy in terms of overall survival.
But the question is, can we actually change those curves? Can we move those curves by adding on an an anemia directed agent. So if we add on something like luspatercept or any one of these number of agents that we’ve discussed, can we then allow for ruxolitnib to be dosed at a higher level? Can we then allow for a lack of transfusion requirement.
So really take away two of those variables, which would then maybe shift that curve into someone who’s not going to do as well to someone who will do much better. And I think that’s something that we really don’t know the answer to that. But I think that’s one of the reason these anemia acting agents could be so critical is we can shift someone with a worse overall prognosis or expected prognosis, maybe into a better a better outcomes or better expectations for how they’ll do.
