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SOHO 2026 | Evolving treatment landscape in ET, PV, and MF: does MF still represent the greatest unmet need?
Prithviraj Bose, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, discusses the evolving treatment landscape in essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF). Dr Bose highlights MF as the area of greatest unmet need, with JAK inhibitors remaining the only approved therapies and a poorer prognosis than ET and PV, which have benefited from recent approvals and emerging disease-modifying approaches. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
I think MF presents still the greatest unmet need. You know, if you think of it from a theoretical scientific standpoint, of course, there are very interesting questions in ET and PV as well, right? But I think with MF, the unmet need is greater. The prognosis is worse. You know, we have not made progress beyond the four JAK inhibitors. That’s all we have approved today. And whereas actually in ET and PV, we are just coming off of two very recent approvals...
I think MF presents still the greatest unmet need. You know, if you think of it from a theoretical scientific standpoint, of course, there are very interesting questions in ET and PV as well, right? But I think with MF, the unmet need is greater. The prognosis is worse. You know, we have not made progress beyond the four JAK inhibitors. That’s all we have approved today. And whereas actually in ET and PV, we are just coming off of two very recent approvals. So there’s been I would say the needle has been moving a bit more in ET and PV. Ropeg is now approved for ET as of like two or three weeks ago. And rusfertide is approved for PV. That’s a new addition to the arsenal there. So I think, you know, ET and PV are moving towards disease modification, newer mechanisms. It’s nice to see drugs getting approved. Now, MF has been tougher. You know, we have the four JAK inhibitors. We don’t have anything else approved yet. Again, certainly hopeful for drugs like luspatercept, selinexor, which have completed their Phase IIIs and shown some very promising results. Also, with some uncertainties about their, you know, approval because of certain endpoints being missed, as I covered in some of the other questions we just had. And I think in MF, you know, especially with the high rates of transformation to AML, you know, the fact that the JAK inhibitors are very, you know, they greatly benefit patients in terms of how they feel. And momelotinib improves anemia as well. But we know that JAK inhibitors don’t substantially modify the underlying disease or change the trajectory of the disease or prevent adverse outcomes like AML or progressive MF. So we know that we are fairly limited in what we can do in that regard, right? We can make people feel well for a few years, but it still progresses. So I think the unmet needs are greatest in MF.
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