JAK2 inhibitor therapy in myeloproliferative disorders: Rationale, preclinical studies and ongoing clinical trials

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Abstract

The recent identification of somatic mutations such as JAK2V617F that deregulate Janus kinase (JAK)-signal transducer and activator of transcription signaling has spurred development of orally bioavailable small-molecule inhibitors that selectively target JAK2 kinase as an approach to pathogenesis-directed therapy of myeloproliferative disorders (MPD). In pre-clinical studies, these compounds inhibit JAK2V617F-mediated cell growth at nanomolar concentrations, and in vivo therapeutic efficacy has been demonstrated in mouse models of JAK2V617F-induced disease. In addition, ex vivo growth of progenitor cells from MPD patients harboring JAK2V617F or MPLW515L/K mutations is also potently inhibited. JAK2 inhibitors currently in clinical trials can be grouped into those designed to primarily target JAK2 kinase (JAK2-selective) and those originally developed for non-MPD indications, but that nevertheless have significant JAK2-inhibitory activity (non-JAK2 selective). This article discusses the rationale for using JAK2 inhibitors for the treatment of MPD, as well as relevant aspects of clinical trial development for these patients. For instance, which group of MPD patients is appropriate for initial Phase I studies? Should JAK2V617F-negative MPD patients be included in the initial studies? What are the likely consequences of 'off-target' JAK3 and wild-type JAK2 inhibition? How should treatment responses be monitored?

Original languageEnglish (US)
Pages (from-to)23-30
Number of pages8
JournalLeukemia
Volume22
Issue number1
DOIs
StatePublished - Jan 2008

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Myeloproliferative Disorders
Clinical Trials
Phosphotransferases
Janus Kinases
Therapeutics
Mutation
Growth
Transducers
Stem Cells

ASJC Scopus subject areas

  • Cancer Research
  • Hematology

Cite this

JAK2 inhibitor therapy in myeloproliferative disorders : Rationale, preclinical studies and ongoing clinical trials. / Pardanani, Animesh D.

In: Leukemia, Vol. 22, No. 1, 01.2008, p. 23-30.

Research output: Contribution to journalArticle

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