Controversies in CML and MPNs

At the 2nd Annual HemOnc Pulse Live!, a panel discussion provided in-depth insights on the evolving management strategies for chronic myeloid leukemia (CML) and myeloproliferative neoplasms (MPNs). Moderated by Naval G. Daver, MD of The University of Texas MD Anderson Cancer Center, the session highlights how the introduction and refinement of tyrosine kinase inhibitors (TKIs) have transformed CML from a once-fatal disease into a highly manageable condition. The panel explores current efforts to identify patients eligible for treatment-free remission (TFR), as well as emerging strategies to achieve deeper molecular responses in MPNs through combination therapies.

Panelists:

• Fadi Haddad, MD, The University of Texas MD Anderson Cancer Center
• Idoroenyi Amanam, MD, City of Hope
• Michael J. Mauro, MD, Memorial Sloan Kettering Cancer Center
• Naseema Gangat, MBBS, Mayo Clinic
• Pankit Vachhani, MD, University of Alabama at Birmingham.
• Prithviraj Bose, MD, The University of Texas MD Anderson Cancer Center

Key topics include the growing ability to safely discontinue TKIs in select CML patients with favorable risk profiles and deep molecular responses. The panelists review real-world data and international clinical trials that support treatment discontinuation in specific scenarios, signaling a major shift toward long-term remission and potential cure.

For MPNs, the discussion addresses the limitations of current JAK inhibitor, such as ruxolitinib, fedratinib, pacritinib, and momelotinib, and the need for more curative strategies. The panel explores the potential of combination therapies, including hypomethylating agents, BET inhibitors, and BCL2/BCL-XL inhibitors, many of which are currently being tested in late-phase trials.

Together, these expert insights offer a compelling look at where CML and MPN care is headed—from disease control to personalized approaches aimed at long-term remission and functional cure.