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The Pros and Cons of Interferon As an MPN Treatment

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Published on February 6, 2018

How does interferon work as a targeted treatment for myeloproliferative neoplasms (MPNs)? What are the benefits and risks of this therapy? MPN expert Dr. Abdulraheem Yacoub, from the University of Kansas Medical Center, explains how interferon works to treat patients with polycythemia vera (PV), essential thrombocythemia (ET) and early stage myelofibrosis (MF), including potential side effects and typical therapeutic response. Watch now to find out if interferon could be right for you.

Produced in partnership with The University of Texas MD Anderson Cancer Center. We thank Incyte Corporation for their support.

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Transcript | The Pros and Cons of Interferon As an MPN 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.

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. 

Beth Kart Probert:

What is peginterferon alfa-2a (Pegasys), exactly, and who is it right for? And this is, I think, a great question because we heard some people say no, we didn’t get along. And you got me saying Pegasys is my best buddy. So, Dr. Yacoub, did you want to address that?

Dr. Yacoub:         

So it’s really great that we have options. That’s really the bottom line here, because there isn’t going to be one drug that is the best drug for everybody. And, according to the European guidelines and the American guidelines now, both hydroxyurea (Hydrea) and interferons, in general, are listed as first-line therapy. So, Pegasys is just one brand of the long-acting interferons, just to kind of be specific. So, interferons are hormones. We all have interferons. We make interferons to boost our immune system to fight infections.

So, if you get influenza, the influenza is an infection in your nose and your pharynx. But then, you feel sick all over. It’s because your body is making so much interferon to fight the influenza that all of your body is aching and hurting and having fevers. So, we’ve learned, a long time ago, that if you use interferons in high enough doses, you can boost the immune system to even fight cancer. And we use interferons over the years to fight kidney cancer. We’ve cured kidney cancer with it. We’ve cured melanomas with it. We’ve cured CMLs with it.

So, over the years, we’ve learned that interferon us a very powerful tool to boost the immune system to fight cancer. We also use it to eradicate hepatitis C infections. So, it is a very good tool to boost the immune system. And it’s the first immune therapy really in our literature. Now, the modern era, we have interferons manufactured in a chemically modified way where we add pegylatedsugars to it, which makes it long acting.

So, this way, one injection would last a week to two weeks instead of the daily injections that you used to get or even infusional therapy that we had to get, at one point. So, you have a more long acting molecule. You don’t get all of these swings in interferon levels during the day. You don’t have nearly as much side effects with it. So, this way, we’re able to use it in a higher dose and in a longer duration dose more effectively. So, we’re actually using it at the much bigger doses than the historic doses we used back then and in other diseases.

And there have been many trials using interferon in patients with ET and in patients with polycythemia vera and some patients with early myelofibrosis. And, consistently, it produces a high response rate.

And that is anywhere between 40 and 80 percent, but it depends on how you do your spicing and define your response. But, consistently, you end up with good response in that. Not 100 percent because you have patients that can’t handle it. You have patients who have side effects to it. You have patients who are allergic to it. You have patients with contraindications to it, which is a big box now, which is contraindications to immune therapy as having uncontrolled autoimmune disease because, once you stimulate the immune system, you can actually cause harm if you have lupus or RAA or other autoimmune disease.

So, if you use the immune system correctly, we have been very successful at using Pegasys and similar medicines in treating cancer. And ET and polycythemia vera, there have been head to head trials comparing hydroxyurea to Pegasys. And those studies are maturing.

We’ll have a lot more data soon. But they seem to be doing equally well in different patients. So, some patients do great with hydroxyurea. Some patients do great with interferon. They’re not the same patients. So, it’s good to have patients who are going to fly with one option, but they don’t do well with it, so, they have another option for them, which has a very good response rate. So, that’s in a nutshell what interferons are. There’s a lot of twists and details in that process. There’s a lot of pre-screening you want to do before you use interferon in patients. The big box is, if you have an uncontrolled immune problem, it can cause harm.

And if you have depression, it can cause harm because it does increase depression. So these are the two boxes where you want to avoid interferons. But for the right patients, it can be a very good and very effective 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. 

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