Ruben Mesa, MD of the Mayo Clinic, Phoenix, AZ talks about ruxolitinib for myelofibrosis. In the long-term, ruxolitinib is favorable, with clear survival advantages. Individuals with extra anemia that develops with ruxolitinib probably do not have their survival limited in any way. Further, some combinations are promising; in particular, ruxolitinib with hypomethylation therapy (azacitidine or decitabine) in at least a subset of patients such those with more advanced disease. Additionally, Prof. Mesa suggests that the best dosing strategy is to use ruxolitinib first, then adding a hypomethylating agent as a second component as opposed to starting them concurrently. Furthermore, preliminary results of a study with ruxolitinib in combination with a PI3K delta inhibitor, TGR-1202 (NCT02493530), were favorable. Recorded at the 2016 American Society of Hematology (ASH) Annual Meeting, held in San Diego, CA.