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Beyond Today: An Expert View of the Future of Myelofibrosis Treatment

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Published on October 25, 2016

Should you ask your doctor about participation in clinical trials? Dr. Olatoyosi Odenike, MPN expert and clinical researcher at the University of Chicago Medical Center, says she â??absolutely encouragesâ?? participating in clinical trials. With study and understanding of myelofibrosis gaining much ground in the past decade, Dr. Odenike reports that new therapies are in the pipeline, including treatments that combat resistance to JAK inhibitor agents. â??It is always reasonable to ask,â?? Dr. Odenike states, â??would a clinical trial be applicable and relevant?â??

This town meeting was sponsored by the Patient Empowerment Network, which received an educational grant from Incyte Corporation. It was produced by Patient Power in partnership with The University of Texas MD Anderson Cancer Center.

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Transcript | Beyond Today: An Expert View of the Future of Myelofibrosis Treatment

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

Hello and welcome to Patient Power. I'm Andrew Schorr. Well, those of us who are living with an MPN have to be very grateful that younger physicians are excited about working in the field and helping us.  And here's one from the University of Chicago Olatoyosi Odenike—did I get it right? 

Dr. Odenike:

Very close.  

Andrew Schorr:

…an MPN specialist at the University of Chicago.  You decided to go into this field… 

Dr. Odenike:

Yes. 

Andrew Schorr:

...when not much was happening, and now a lot more is happening. 

Dr. Odenike:

Right.

Andrew Schorr:

Right. Are you encouraged for those of us, for instance, living with myelofibrosis?

Dr. Odenike:

Yes, I'm very, very, very encouraged. So, as many of our listeners may know, this is a field where we had very little knowledge, I would say, you know, a little over a decade ago about the genes involved in the pathogenesis of myelofibrosis, and when you have very little knowledge about what causes a disease to be initiated and to progress, it's—becomes doubly challenging to be able to find a way to effectively treat this disease.

So we are gratified by the advances that we have, you know, collectively made together into figuring out over the past 10 years plus now of the genes involved in the pathogenesis of myelofibrosis. And this, of course, is paving the way for new treatments and approaches for individuals afflicted with this disorder.  

Andrew Schorr:

So let me make sure we all understand.

Dr. Odenike:

Yes.

Andrew Schorr:

First, you've got to figure out what are you dealing with… 

Dr. Odenike:

Right.

Andrew Schorr:

…and now we're looking at it genetically. What are these aberrations that happen in our genes that are producing the cancer, and then how do you develop treatments that sort of turn them off?

Dr. Odenike:

Exactly.

Andrew Schorr:

Okay. So for me and for many people, we're taking a JAK2V617F inhibitor, right?

Dr. Odenike:

Yes. 

Andrew Schorr:

So there's one approved. There may be others that develop. 

Dr. Odenike: 

Right. 

Andrew Schorr:

So we wonder, well, if we turn that off, though, will we develop—will the cancer outsmart our drug. I think you call it resistance. 

Dr. Odenike:

Right.

Andrew Schorr:

And will you have something else. So when you look at sort of a pipeline of development of what you're working on, is there hope for us that if one medicine either doesn't work or stops working, you'll have something else?

Dr. Odenike:

Right. Yes, there is hope.  So there are a number of agents along the—the subtype, I would say, of JAK inhibitors that are being developed.  So Jakafi, or ruxolitinib, is the one that is currently FDA?approved and has been FDA?approved now for about five years or so.  But there are a number of other JAK inhibitors that are in clinical trials, and one of the hopes, you know, one of the basic premises of developing those inhibitors is, you know, hoping that if one stops working, there will be others along the line that patients can take. 

We draw some of our experience in terms of treating patients with myelofibrosis from the treatment of other diseases, which are not exactly myelofibrosis—myelofibrosis is complex—but which can inform us anyway about how to approach patients with myelofibrosis. So when we think about chronic myeloid leukemia, for example, which is a disease for which there are ABL kinase inhibitors that target BCR?ABL, we know that early on there was one that was FDA?approved. And it is true some patients did develop resistance that then foiled the development of other ABL kinase inhibiters, which were by and large able to help those individuals in whom resistance has developed. 

This does mean, of course, that we need to figure out what the mechanisms of resistance are if possible. And concurrent with that I think we need to test as many drugs that make sense as possible, you know, that target this pathway and other related pathways in patients with myelofibrosis.

Andrew Schorr:

All right.  That relates to really the bond between patients and a researcher such as yourself, and that is clinical trials.  

Dr. Odenike:

Yes.

Andrew Schorr:

So you're at the University of Chicago. You have trials. We're recording this at MD Anderson. Trials are at different centers around the world, maybe back in Nigeria where you're from as well.

Dr. Odenike: 

 Yes.

Andrew Schorr:

So would you urge people who are listening when they consult with an MPN specialist to have a conversation about trials as well to see if that applies to them? 

Dr. Odenike:

I would absolutely encourage it. You know, as a doctor and also as a clinical investigator who does trials in myelofibrosis and in related diseases, I will say first I have to thank all of our patients very much, every single person who volunteers for a clinical trial, because this is the way by which significant advances have been made in terms of, you know, developing new treatments for tough-to-treat diseases.  

If we did not have participation in clinical trials, we would not be able to have, you know, new and useful drugs approved for folks at large.  A clinical trial may not be for everyone. But I think for every single patient coming through it is reasonable to ask, you know, do—am I in a position where my disease state is at the moment, would a clinical trial be applicable, would it be relevant, would it offer any potential hope or option beyond what I'm doing?

Andrew Schorr:

Well, thank you for the work you do…

Dr. Odenike:

Thank you. 

Andrew Schorr:

…in the research and then in treatment for people every day.  And let's hope that we can all work towards a cure for myelofibrosis, okay? 

Dr. Odenike:

Yes. I definitely second that. 

Andrew Schorr:

Okay. All right.  Well, with Dr. Odenike… 

Dr. Odenike:

 Yes.

Andrew Schorr:

…from the University of Chicago, thank you for all do.  And for our audience, I'm Andrew Schorr.  Remember, knowledge can be the best medicine of all. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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