Pacritinib With Standard of Care Azacitidine or Decitabine as a Bridge to Allogeneic Hematopoietic Stem Cell Transplant for Patients With Accelerated and Blast Phase Myeloproliferative Neoplasms
Key claim: A phase II trial is evaluating whether adding pacritinib to standard-of-care azacitidine or decitabine increases the proportion of accelerated/blast-phase MPN patients able to proceed to allogeneic stem cell transplantation.
Abstract
This phase II trial tests if adding pacritinib to standard of care azacitidine or decitabine increases the number of patients able to proceed to hematopoietic stem cell transplantation (bridging) for patients with accelerated and blast phase myeloproliferative neoplasms. Pacritinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Azacitidine and decitabine are in a class of medications called hypomethylation agents. They work by helping the bone marrow produce normal blood cells and by killing abnormal cells in the bone marrow. Cedazuridine is in a class of medications called cytidine deaminase inhibitors. It prevents the breakdown of decitabine, making it more available in the body so that decitabine will have a greater effect. Adding pacritinib to standard of care azacitidine or decitabine may increase the number of patients able to proceed to hematopoietic stem cell transplantation for patients with accelerated and blast phase myeloproliferative neoplasms.
Why this matters
AP/BP-MPN remains the highest-risk pre-transplant scenario with no established bridging standard, and many patients fail to reach alloHCT due to disease progression or treatment-related cytopenias. Pacritinib’s cytopenia-sparing profile makes it a rational JAK-inhibitor partner for HMAs in this thrombocytopenic population, where ruxolitinib bridging is often poorly tolerated. This trial broadens the emerging JAK-inhibitor + HMA bridging paradigm and could expand the pool of AP/BP-MPN patients eligible for curative transplant.