New generation small-molecule inhibitors in myeloproliferative neoplasms

Curr Opin Hematol. 2012 Mar;19(2):117-23. doi: 10.1097/MOH.0b013e32834ff575.

Abstract

Purpose of review: Myeloproliferative neoplasms (MPNs) are diseases that carry the JAK2 (V617F) mutation in about 70% of the patients. The purpose of this review is to describe the recent advances in the therapy of MPNs with JAK2 inhibitors.

Recent findings: Many drugs are now under investigations targeting different pathways critical for MPN development, such as the JAK-STAT (JAK2 inhibitors: INCB018424 or ruxolitinib, TG101348 or SAR302503, CYT387, SB1518, CEP701 and LY2784544) and the PI3K/AKT/mTOR (everolimus) pathways, or act through remodeling of chromatin with a key role in epigenetics (givinostat, panobinostat and vorinostat). The most relevant effects were spleen size reduction and relief of constitutional symptoms.

Summary: Patients who might benefit from JAK2 inhibitors in clinical practice are mostly those with splenomegaly or with constitutional symptoms. We should alert patients with lower hemoglobin levels that these therapies might, although temporarily, favor the need for red blood cell transfusions.

Publication types

  • Review

MeSH terms

  • Animals
  • Benzamides / therapeutic use
  • Clinical Trials as Topic
  • Disease Models, Animal
  • Drug Evaluation, Preclinical
  • Humans
  • Janus Kinase 2 / antagonists & inhibitors*
  • Janus Kinase 2 / genetics
  • Janus Kinases / antagonists & inhibitors
  • Mice
  • Myeloproliferative Disorders / drug therapy*
  • Nitriles
  • Protein Kinase Inhibitors / therapeutic use*
  • Pyrazoles / therapeutic use
  • Pyrimidines / therapeutic use
  • Pyrrolidines / therapeutic use
  • Sulfonamides / therapeutic use

Substances

  • Benzamides
  • Nitriles
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • Pyrrolidines
  • Sulfonamides
  • fedratinib
  • N-(cyanomethyl)-4-(2-((4-(4-morpholinyl)phenyl)amino)-4-pyrimidinyl)benzamide
  • ruxolitinib
  • JAK2 protein, human
  • Janus Kinase 2
  • Janus Kinases