Platelet count-agnostic methods of treating myelofibrosis
Reanalysis of the SIMPLIFY 1 and 2 trials data indicates MMB is effective in JAKi-naïve patients and in second line therapy to RUX, providing benefits of reducing enlarged spleens, improving myelofibrosis-related symptoms, and increasing transfusion independence in patient at risk for thrombocytopenia from the underlying disease and RUX therapy. Accordingly, methods of treating myeloproliferative neoplasms (MPN) such as myelofibrosis are described. The methods can include administering a therapeutically effective amount of momelotinib or a pharmaceutically acceptable salt thereof to a subject identified as having (i) myelofibrosis and (ii) a platelet count of less than 150×10 9 /L. Also described are methods including administering to a subject with myelofibrosis a therapeutically effective stable dose of momelotinib or a pharmaceutically acceptable salt thereof, for a period of a plurality of weeks, where the subject is assessed as maintaining a platelet count above a predetermined threshold platelet count during the period.
1. A method of treating myelofibrosis in a subject, the method comprising:
administering a therapeutically effective amount of momelotinib or a pharmaceutically acceptable salt thereof to a subject identified as having (i) myelofibrosis and (ii) a baseline platelet count of less than 50×10 9 /L.
2. The method of claim 1 , wherein the baseline platelet count is a baseline platelet count determined within one week prior to initiation of momelotinib therapy, wherein the subject had not been treated with previous JAK inhibitor therapy for at least 2 weeks prior to momelotinib therapy.
3. The method of claim 1 , wherein the subject has previously been treated with a JAK inhibitor.
4. The method of claim 3 , wherein the subject has previously been treated with ruxolitinib.
5. The method of claim 4 , wherein the subject is an adult human who has had an inadequate response to or is intolerant of ruxolitinib or wherein the subject failed to respond or ceased to respond to previous ruxolitinib therapy.
6. The method of claim 3 , wherein the subject has previously been treated with fedratinib.
7. The method of claim 6 , wherein the subject is an adult human who has had an inadequate response to or is intolerant of fedratinib or wherein the subject failed to respond or ceased to respond to previous fedratinib therapy.
8. The method of claim 1 , wherein the subject is naïve to JAK inhibitor therapy.
9. The method of claim 1 , wherein the myelofibrosis is intermediate, intermediate-2, or high-risk myelofibrosis.
10. The method of claim 1 , wherein the myelofibrosis is primary myelofibrosis (PMF) or post-polycythemia vera or post-essential thrombocythemia myelofibrosis (Post-PV/ET MF).
11. The method of claim 1 , wherein the momelotinib or a pharmaceutically acceptable salt thereof is administered orally.
12. The method of claim 1 , wherein the momelotinib or a pharmaceutically acceptable salt thereof is administered once daily.
13. The method of claim 1 , wherein the therapeutically effective amount is between 50 mg/day and 200 mg/day.
14. The method of claim 1 , wherein the subject has thrombocytopenia or neutropenia.
15. The method of claim 14 , wherein the subject has thrombocytopenia.
16. The method of claim 15 , wherein the therapeutically effective amount of momelotinib is about 200 mg/day, about 150 mg/day, about 100 mg/day, or about 50 mg/day.
17. The method of claim 15 , wherein the therapeutically effective amount of momelotinib, or a pharmaceutically acceptable salt thereof, is administered in a first dose of about 200 mg, and subsequent doses of about 150 mg.
18. The method of claim 15 , wherein the therapeutically effective amount of momelotinib, or a pharmaceutically acceptable salt thereof, is administered in a first dose of about 200 mg, a second dose of about 150 mg, and subsequent doses of about 100 mg.
19. The method of claim 15 , wherein the therapeutically effective amount of momelotinib, or a pharmaceutically acceptable salt thereof, is administered in a first dose of about 200 mg, a second dose of about 150 mg, a third dose of about 100 mg, and subsequent doses of about 50 mg.
20. The method of claim 15 , wherein the therapeutically effective amount of momelotinib, or a pharmaceutically acceptable salt thereof, is administered in a first dose of about 200 mg and subsequent doses decreased in 50 mg increments.
21. The method of claim 15 , comprising administering not less than 50 mg/day of momelotinib, or a pharmaceutically acceptable salt thereof.