OVERVIEW OF ACTIVITY
Myeloproliferative neoplasms (MPNs) largely consist of 3 disease entities, all heralding from clonal disorders in which an initial molecular event results in excessive production of blood cells. Importantly, although essential thrombocythemia (ET), polycythemia vera (PV) and myelofibrosis (MF) are clinically distinguishable based on laboratory and molecular parameters, they may represent a disease continuum whereby transformation from ET or PV to the more aggressive MF results in a homogenous pathologic entity with a similarly poor prognosis. In contrast to the rather indolent natural history of untransformed ET and PV, primary MF or post-PV/ET MF is a debilitating disease. Historically no FDA-approved therapy existed, but after the FDA approval of ruxolitinib in 2011 for intermediate- and high-risk MF, including primary MF, post-PV MF and post-ET MF, this agent has rapidly been adopted in clinical practice. Patient selection and dosing of ruxolitinib remain relevant topics of discussion and debate. Not surprisingly, JAK inhibitors have been and continue to be critically evaluated for patients with both PV and ET. Most notably, in December 2014, the US FDA approved ruxolitinib as treatment for patients with PV who have experienced an inadequate response to or are intolerant of hydroxyurea.

To bridge the gap between research and patient care, this issue of Myeloproliferative Neoplasms Update features one-on-one discussions with leading hematology-oncology investigators. Upon completion of this CME activity, medical oncologists and hematologists should be able to formulate an up-to-date and more complete approach to the care of patients with MPNs.

LEARNING OBJECTIVES

• Use an understanding of disease biology and natural history to diagnose primary PV, ET and MF and communicate prognosis to patients.
• Consider the evidence-based therapeutic options for patients with PV, ET and MF, and develop clinical algorithms intended to enhance quality and quantity of life for patients with these distinct yet related diseases.
• Appraise the role of ruxolitinib in patients with MF and thrombocytopenia, anemia and compromised renal function.
• Appreciate emerging research data with the use of novel JAK inhibitors in the care of patients with MF, and prepare for their potential availability in clinical practice.
• Recognize the benefits of ongoing clinical trials for patients with MPNs, and inform appropriately selected patients about these options for treatment.

ACCREDITATION STATEMENT
Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT
CME credit is no longer available for this issue

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This CME activity contains an audio component.
CME credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process: Prof Harrison — Advisory Committee: Celgene Corporation, Gilead Sciences Inc, Novartis, Sanofi Genzyme; Contracted Research: Celgene Corporation, Gilead Sciences Inc, Incyte Corporation, Janssen Biotech Inc, Novartis; Speakers Bureau: Gilead Sciences Inc, Incyte Corporation, Novartis, Sanofi Genzyme. Dr Verstovsek — Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Pfizer Inc, Roche Laboratories Inc.

EDITOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantor.

This activity is supported by an educational grant from Incyte Corporation.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
Adobe Flash Player 10.2 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Release date: October 2017
Expiration date: October 2018