iwMPN 2026 | How meaningful benefit in MPNs could evolve over the next five years

I do think in the future that we will have greater insights into the biology of progression. You know, one of the greatest unmet needs we have in MPNs that I think we’re gaining insight into is why do people progress? Because I had mentioned earlier in our conversations that patients can do one of two things. They can live longer or they can live better. Now, the living longer thing is very important to both physicians, patients, and loved ones. Without question, the fear of progression and progression as a surrogate for premature mortality from the disease is something everyone really fears. So I’m hopeful that in the future, whether it be histologic markers we haven’t yet identified, whether we gain further insight in terms of what molecular thresholds are meaningful. You know, we can measure changes in variant allele frequency, but we do not have validation as to what level of reduction really is necessary. As well as individuals can have multiple additional mutations, what changes in the whole somatic profile that’s important. You know, if you have the JAK2 that’s decreased, but you have two other mutations, you know, what does that mean? So I think we still don’t fully know, but I’m very hopeful that five years from now, that will be something we have much greater insight into and then it will really help guide, you know, probably a larger number of therapies that we have available: who should be on what therapy, do we optimize dose, you know, how do we adjust dose for folks, are we able to achieve treatment-free remission, so that really is that crucial biological metric we need. Why do people progress? Where does that individual patient stand in terms of risk of progression? How do we adjust our medical therapy to really optimize the chance that that individual does not progress?

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