Defining disease modification in myelofibrosis in the era of targeted therapy

Naveen Pemmaraju, Srdan Verstovsek, Ruben Mesa, Vikas Gupta, Jacqueline S. Garcia, Joseph M. Scandura, Stephen T. Oh, Francesco Passamonti, Konstanze Döhner, Adam J. Mead

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


The development of targeted therapies for the treatment of myelofibrosis highlights a unique issue in a field that has historically relied on symptom relief, rather than survival benefit or modification of disease course, as key response criteria. There is, therefore, a need to understand what constitutes disease modification of myelofibrosis to advance appropriate drug development and therapeutic pathways. Here, the authors discuss recent clinical trial data of agents in development and dissect the potential for novel end points to act as disease modifying parameters. Using the rationale garnered from latest clinical and scientific evidence, the authors propose a definition of disease modification in myelofibrosis. With improved overall survival a critical outcome, alongside the normalization of hematopoiesis and improvement in bone marrow fibrosis, there will be an increasing need for surrogate measures of survival for use in the early stages of trials. As such, the design of future clinical trials will require re-evaluation and updating to incorporate informative parameters and end points with standardized definitions and methodologies.

Original languageEnglish
Pages (from-to)2420-2432
Number of pages13
Issue number13
StatePublished - Jul 1 2022


  • bone marrow fibrosis
  • disease modification
  • myelofibrosis
  • myelofibrosis pathophysiology
  • targeted therapy


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