Panelists discuss how investigational therapies beyond Janus kinase (JAK) inhibition, including epigenetic modulation, telomerase inhibition, PI3K/AKT/mTOR pathway inhibition, immune modulation, TGF-β inhibition, and novel anti-fibrotic agents, are showing promise in improving efficacy and targeting different disease pathways in myelofibrosis.
Panelists discuss how steroid dosing for chronic graft-vs-host disease (cGVHD) typically starts at 0.5-1 mg/kg/day depending on severity, with careful tapering to avoid flares.
Panelists discuss how patient education and multidisciplinary involvement are critical for early detection of chronic graft-vs-host disease (cGVHD).
Panelists discuss how the MOMENTUM trial demonstrated momelotinib’s superiority over danazol in symptomatic anemic myelofibrosis patients, showing significant improvements in symptoms (the primary end point), meaningful spleen volume reduction (SVR25/SVR35), and anemia benefits, with experts noting that the inclusion of a washout period provided clearer evidence of momelotinib’s efficacy profile compared to the SIMPLIFY-2 trial.
Panelists discuss how second-line treatment decisions for myelofibrosis patients failing ruxolitinib can be guided by clinical trial data such as that from SIMPLIFY-2, whereas momelotinib offers comparable spleen control with superior anemia benefits and potential symptom improvement, although experts emphasize the importance of considering a patient’s specific failure pattern and setting appropriate expectations when switching therapies.
Panelists discuss how managing myelofibrosis patients with challenging cytopenias involves careful treatment selection, regular monitoring of blood counts, and tailored dose adjustments to balance disease control with the risks of exacerbating hematologic toxicities.
Panelists discuss how selecting and optimizing Janus kinase (JAK) inhibitor therapy in myelofibrosis involves personalizing treatment based on patient risk factors, comorbidities, and preferences while emphasizing regular monitoring to manage adverse effects and improve quality of life.
Panelists discuss how difficult-to-diagnose cases of chronic graft-vs-host disease (cGVHD) often include pulmonary involvement, gynecological manifestations, and neurological symptoms.
A panelist discusses how successful management of chronic graft-vs-host disease (cGVHD) requires a multifaceted approach that combines prompt recognition, strategic intervention, and comprehensive supportive care to optimize both disease control and quality of life for transplant survivors.
Panelists discuss how clinicians typically diagnose chronic graft-vs-host disease (cGVHD) based on clinical features rather than biopsies, except in atypical or uncertain cases.
An expert discusses how addressing unmet needs in early diagnosis, treatment options, and long-term management, alongside exploring targeted therapies, combination approaches, and advancements in stem cell transplantation, holds promise for more effective and less toxic treatments for blastic plasmacytoid dendritic cell neoplasm (BPDCN).
An expert discusses how structuring clear roles, fostering communication, and using technology in the shared-care model between academic and community centers, alongside monitoring blood glucose levels, kidney function, and comorbidities, ensures effective collaboration and safe use of tagraxofusp (TAG) therapy.
An expert discusses how effective use of tagraxofusp in blastic plasmacytoid dendritic cell neoplasm (BPDCN) requires proactive monitoring for capillary leak syndrome, liver toxicity, and myelosuppression, with structured protocols and multidisciplinary coordination—especially in community settings—to ensure early intervention and safe, successful treatment delivery.
An expert discusses how treatment selection in blastic plasmacytoid dendritic cell neoplasm (BPDCN) involves balancing disease-specific targeting and patient fitness, with tagraxofusp remaining the frontline standard due to its efficacy and favorable hematologic recovery, whereas venetoclax/azacitidine may be reserved for less fit patients or relapsed settings.
An expert discusses how effective blastic plasmacytoid dendritic cell neoplasm (BPDCN) management requires early central nervous system (CNS) evaluation and a multidisciplinary approach, with treatment decisions guided by disease burden, patient fitness, and CNS involvement—highlighting the need for systemic tagraxofusp combined with prompt intrathecal therapy to address high-risk features.
Panelists discuss how Janus kinase (JAK) inhibitors like pacritinib offer crucial treatment options for myelofibrosis patients with severe thrombocytopenia (platelet counts <50,000 ), highlighting its advantages in providing significant spleen volume reduction (29% vs 3% in PERSIST-2 trial) while also offering unexpected anemia benefits possibly due to ACVR1 inhibition, with clinicians noting they set realistic expectations about platelet stabilization rather than improvement when counseling patients.
Panelists discuss how Janus kinase (JAK) inhibitor dosing strategies must be carefully tailored for anemic myelofibrosis patients, with clinical experience suggesting starting at lower doses (10 mg twice daily ) and gradually escalating based on the REALIZE trial approach, while balancing efficacy goals against cytopenia risks and monitoring unique toxicity profiles of different JAK inhibitors including Wernicke encephalopathy with fedratinib and gastrointestinal issues with pacritinib.
An expert discusses how the diagnosis and management of blastic plasmacytoid dendritic cell neoplasm (BPDCN) require careful recognition of characteristic dermatologic and hematologic features, with tagraxofusp as frontline therapy and vigilant monitoring for central nervous system (CNS) involvement and treatment-related toxicities to guide a multidisciplinary care approach.
A panelist discusses how the MARIPOSA, SKIPPirr, and COCOON studies highlight the significant overall survival benefit of the amivantamab and lazertinib combination in first-line treatment for EGFR-mutant non–small cell lung cancer (NSCLC), while also emphasizing the importance of proactive management of adverse events (AEs), which may shift the standard of care and improve patient tolerability and adherence.
Panelists discuss how managing asymptomatic splenomegaly in myelofibrosis requires a nuanced approach, balancing observation in low-risk patients with early intervention using Janus kinase (JAK) inhibitors in higher-risk cases, while emphasizing the importance of regular monitoring, patient preferences, and shared decision-making.
A panelist discusses how strategies such as clear patient education, simplified skin care regimens, personalized recommendations, and regular follow-ups, along with family involvement and addressing barriers to adherence, can significantly improve patient adherence to prophylactic dermatologic care, leading to better management of dermatologic adverse events (DAEs) in cancer treatment.
Panelists discuss how survival data from the COMFORT trials support the use of ruxolitinib in myelofibrosis, especially in intermediate- to high-risk patients with significant symptom burden or splenomegaly, while highlighting the need to consider patient selection, crossover effects, and real-world applicability when interpreting these results.
A panelist discusses how proactive management of dermatologic adverse events (DAEs) in cancer treatment, through early detection, tailored interventions, and collaboration with specialists such as dermatologic oncologists, advanced practice providers (APPs), and pharmacists, significantly enhances patient comfort, treatment adherence, and overall outcomes.
Panelists discuss how posttransplant cyclophosphamide has changed the clinical presentation of chronic graft-vs-host disease (cGVHD), with potentially lower incidence but similar severity when it does occur.
Panelists discuss how chronic graft-vs-host disease (cGVHD) results from complex biological mechanisms involving inflammation, loss of peripheral tolerance, and fibrotic pathways affecting multiple organ systems.
A panelist discusses how the treatment landscape for chronic graft-vs-host disease (cGVHD) has evolved significantly in recent years, with several pivotal clinical trials beyond REACH3 informing our approach, including the REACH1 and REACH2 trials for acute GVHD; the ROCKstar trial supporting belumosudil approval; and studies evaluating ibrutinib, axatilimab, and extracorporeal photopheresis.
Panelists discuss how clinical trial data from the COMFORT studies supports using Janus kinase (JAK) inhibitors such as ruxolitinib for myelofibrosis patients beyond the original high-risk study population, with experts noting they often treat intermediate-1-risk patients based on symptomatic burden and splenomegaly rather than risk stratification alone to achieve meaningful spleen volume reduction and symptom improvement.
Panelists discuss how treatment goals for intermediate-risk myelofibrosis patients focus on achieving meaningful clinical outcomes including relieving symptoms, preventing worsening of anemia, maintaining transfusion independence, reducing symptomatic splenomegaly, and ultimately improving survival while considering patient-specific factors like age and transplant eligibility.
A panelist discusses how the COCOON study's findings will lead to the integration of enhanced dermatologic management into clinical practice for patients receiving amivantamab and lazertinib, focusing on proactive care to reduce dermatologic adverse events (DAEs), improve patient comfort, and increase treatment adherence, ultimately optimizing patient outcomes.
Panelists discuss how initiating therapy in myelofibrosis requires a personalized approach that balances symptom burden, risk stratification, cytopenias, and patient goals, with treatment decisions—often involving Janus kinase (JAK) inhibitors—tailored to optimize both disease control and quality of life.