In this HealthTree for Myelofibrosis podcast episode, we spoke with Dr. John Mascarenhas about the SENTRY Trial (NCT04562389). Dr. Mascarenhas is the principal investigator on this global, phase III clinical trial, which is looking at combining the JAK2 inhibitor Ruxolitinib with the XPO1 inhibitor Selinexor for myelofibrosis patients who have not previously been on a JAK inhibitor. The trial is actively enrolling  350 patients and aims to report top-line results in the second half of 2025.

 

Both Ruxolitinib and Selinexor are FDA-approved therapies. Ruxolitinib is approved for use in the treatment of myelofibrosis, while selinexor is currently approved for the management of other hematologic malignancies. This trial is looking to see if combining ruxolitinib with selinexor provides a better outcome for patients than ruxolitinib alone. People who participate in this trial will receive ruxolitinib+selinexor or ruxolitinib+, a placebo, meaning everyone participating in the study will receive ruxolitinib. In early phase I testing, combining the two therapies demonstrated a favorable safety profile with no new adverse signals. 

 

The two primary metrics evaluated in this study are spleen reduction and total symptom burden reduction. Participants in this trial may have increased monitoring and testing during the duration of the study but, importantly, should not pay more for their treatment or care by participating in this study. Primary outcomes of the trial will be evaluated at 24 weeks but patients will be followed for an extended duration. Dr. Mascarenhas emphasizes that safety is at the forefront of all clinical trials. 

 

Dr. Mascarenhas recommends that anyone eligible or interested in their trial speak with their doctor about it. 

Dalton Bean (00:13)

Hi, and welcome to the Health Tree Foundation podcast for myelofibrosis, a show that connects patients with researchers. I'm your host Dalton Bean. This will be our first podcast installment for myelofibrosis, and it should serve as a very exciting start for this new group of events which we'll be hosting periodically. This episode will cover a phase three clinical trial studying the combination of Selinexor with Ruxolitinib for myelofibrosis, known as the SENTRY trial. The trial evaluates the combination of the JAK inhibitor Ruxolitinib with the XPO1 inhibitor Selenexor and is actively enrolling in late 2024 and early 2025. Joining us for this podcast is Dr. John Mascarenhas. And before we get into our conversation with Dr. Mascarenhas, I'd like to take a moment to introduce him. Dr. Mascarenhas is a professor of medicine at the Icahn School of Medicine, where he serves as the director of the Center of Excellence for Blood Cancers and Myeloid Disorders. Additionally, Dr. Mascarenas directs the Adult Leukemia Program and is a member of the Tisch Cancer Institute. Dr. Mascarenas is an internationally renowned leader in the MPN research and care space and is the principal investigator of the Phase III SENTRY Trial, which we'll be discussing today.

 

Dalton Bean (01:27)

Thank you for joining us Dr. Mascarenhas To start off, I'd love if you could give us a quick overview of what the SENTRY trial is trying to look at, evaluating, as well as what the primary endpoints of this trial are.

 

John Mascarenhas, MD (01:41)

Sure, thanks for having me. And the SENTRY trial is really an important trial that's trying to evaluate whether combination therapy in myelofibrosis patients is superior to the standard of care of monotherapy with ruxolitinib, the JAK1-2 inhibitor. The agent of interest in the SENTRY study is selinexor which is an XP01 inhibitor, which has already demonstrated both activity as a single agent in the relapse refractory setting after JAK inhibitor but also in a phase one study, activity as a combination up front in JAK inhibitor naive patients showing deep spleen and symptom responses. So the phase three study is trying to confirm that it is in fact superior to single agent Ruxolitinib and the primary endpoints will be the standard ones, the spleen volume response at 24 weeks looking for a deeper response with the combination, but also improvement upon symptom response with selinexor or what I think is probably important to highlight upfront is that the traditional TSS50, which is a scoring system, a patient reported outcome that's been used most frequently in these studies, looking at a 50 % reduction in symptom burden in patients at 24 weeks after therapy. And this study has been updated with agreement with the FDA to look at the mean change in the absolute total symptom score. So sort of a different twist on looking at the symptoms to try to better appreciate how the impact of adding a drug like selinexor can benefit patients in terms of absolute reduction in their symptom burden. And this sort of signifies in many ways a potential paradigm shift, the way that FDA views these endpoints. But more importantly, from a patient's perspective,

 

The real question is going to be is if you add a drug like Selinexor, which is rational, and there's a lot of pre-clinical data, we can talk about that, support that, can we do better than single agent ruxolitinib? And really the 24-week readout is the early readout, but the readout that think that a lot of patients are going to most be interested in, investigators for sure, is over time, can we demonstrate that patients stay on the combination, benefit in a durable way, and that that ultimately translates to better progression-free survival, overall survival other endpoints that are really critical to patients.

 

Dalton Bean (04:07)

Yeah, that sounds really exciting and correct me if I'm wrong, but looking at symptom burden, that's not typically evaluated in every clinical trial. That does make this trial a little bit more unique or perhaps it's a new wave of clinical trials where they're going to start integrating the symptom burden, correct?

 

John Mascarenhas, MD (04:23)

Well, in oncology, symptom burning is not frequently an endpoint that a FDA or a regulatory body would approve a drug in. In myelofibrosis, it is an important endpoint, and it has historically been used in the approvals of JAK inhibitors. And that really set the tone many years ago for introducing drugs that both address the symptoms, which are a very significant part of having myelofibrosis.

 

And those can be systemic symptoms like fevers, night sweats, weight loss, to other types of symptoms that can manifest like spleen related symptoms, early satiety, difficulty eating, bloating, pain, bone pains, fatigue, major symptom, and just generally not feeling well in malaise. Patients with these diseases can, and of course it's very heterogeneous. Some patients may be listening and saying, well, I have some of those or I don't have all of those or I have all of those. It's really very variable in what patients experience, but symptoms are clearly a component of it. We think it's inflammatory driven; it's a very inflammatory disease. this total symptoms score has always really been integrated into at least a key secondary endpoint for approval of, JAK inhibitors. But what we're moving into now is an era of trying to evaluate, there better ways of appreciating the responses of these drugs. Beyond deeper spleens, which is what drugs like Cell and Exor have demonstrated in their studies, then single-aged or ruxolitiniblanib. But can we improve, for example, the change in absolute TSS? So reducing that score, it's scored from zero to 10, different aspects of symptoms. Can we take that score and really significantly reduce it across lots of different patients? And that's really gonna be sort of the key. So it's integrating symptomatology or the change symptomatology and the assessment of it in a novel way.

 

Dalton Bean (06:21)

That sounds like it'd be really helpful for a patient potentially interested in joining this trial of knowing that their symptoms really are being studied here. And it's not just looking at spleen volume reduction, but really trying to figure out does this combination therapy help you feel better? And I think that's something that a lot of patients would be interested in. So you mentioned some of the symptoms, but how many symptoms are being evaluated? Can you just give us a quick list of what those symptoms are?

 

John Mascarenhas, MD (06:48)

Yeah, I mean, it's the symptoms that I've noted. It's really symptoms that we know can be attributed to the disease that are frequent in disease. And that can be, again, the spleen-related symptoms. So it's discomfort under your left rib and early satiety, pains in the bones, energy level and activity level, and night sweats. Itching is a symptom that a lot of patients can complain about.

 

What's interesting about these is the itching sometimes can be water-induced. It can be aquagenic pruritus, which is somewhat unique about these myeloproliferative neoplasms. So it's really looking at a number of different symptoms and trying to score them and try to understand how they improve. But what I think really becomes key for patients to appreciate is, although symptoms are clearly important and trials are evaluating symptoms,

 

It's really the totality of like, is the addition of an agent like Selinexor really bringing to the table? And this would be true, I would say, of any drug that's being evaluated or any combination. It's not particularly to Selinexor, but since we're talking about Selinexor and the data is pointing in this direction, it's can we get better everything? Can we get better spleen reduction? Can we get better symptom improvement? Can we get other, what we call markers of disease modification changing in a more profound way like reduction in bone marrow fibrosis, reduction in driver mutation levels that are measured in the blood, reduction in what are called cytokines, inflammatory markers, things that we can measure that are now integrated sort of routinely into these studies. Do we see these markers moving in general across the patients in a better direction and a more profound direction than a single-agent drug like ruxolitinib. But again, I can still say from a patient's perspective and from everyone's perspective, what we ultimately want to see is that this all translates to, and this is the longer term outcome, not the early outcome, but does this translate to better long-term outcomes? Disease-free survival or progression-free survival, I should say and then overall survival. Are we really impacting disease in such a profound way with these early readouts that we see the payoff at the end with patients who are living a longer, better quality of life?

 

Dalton Bean (09:13)

You mentioned that it'll be a 24 week is kind of a short term timeline. Do you know long term timeframe on this trial?

 

John Mascarenhas, MD (09:21)

Yeah, so the investigators and the sponsor are committed to following patients through their course of disease. So meaning that the readout for almost every trial we do is usually within a six month, a 24 week period, looking at the spleen, the symptoms, and various other aspects. But patients would continue to be either treated on drug or followed over time to make sure that we also can confirm and document that patients are enjoying benefit, whether they remain on therapy or not, for the longer term, that their clinical course is better. For example, patients who get the combination, we're hoping that will translate to deeper responses. Those deeper responses may be measured in the short term by spleen and symptom improvement, but in the long term with survival. So we'll be following the patients out and we're hoping that we can prove that.

 

Dalton Bean (10:02)

And then I know that this is going to be a big question amongst a lot of people, but what are some of the known side effects of selinexor ruxolitinib? Ruxolitinib is probably a little bit more well-known since it is one of the standard treatments right now, but could you cover just some of the side effects of each one of these agents?

 

John Mascarenhas, MD (10:15)

Sure, so Ruxolin and the JAK 1, 2 inhibitors. So you do get some myelo suppression. You can get some reductions in the white count less so, but red count and platelet count. And they're pretty predictable. you know, it's well described. We know the cadence of what the counts will do. But Ruxolin rarely improves blood counts, but it does improve symptoms. It's a really good drug for improving symptoms. And that makes it hard actually to add other drugs and prove that the symptoms can get even better.

 

And Roxolinib is a very good drug in terms of shrinking spleen. But some complications I can sue is you can have infections at a low rate, but there's some immunosuppressive properties, and there can be some weight gain. Usually that's a good thing, patients who are not doing well or gaining weight, was it just better nutrition and better outcome. But in general, a pretty well tolerated drug.

 

Selinexor is a drug that's been approved for different malignancies like multiple myeloma in combinations with other active agents in multiple myeloma. And the doses we're using in myelofibrosis in the SENTRY study are lower doses than we used previously in multiple myeloma, once a week dosing. And we're paying attention to adverse events of interest. We know that with selinexor, which affects a lot of different relevant pathways to myelofibrosis that one can have GI toxicity. That can be like nausea and diarrhea, for example. So there's a lot of attention to optimizing patients with the dosing with an anti-nausea medication or an anti-diarrhea, which significantly reduces that type of toxicity that can be seen. And some patients can have astentia, which means they sort of feel fatigued or tired with the drug. And that's where I think the interesting part about balancing toxicities. So the addition of ruxolitinib likely improves the tolerability of drugs like selinexor. And even at low doses of ruxolitinib, we've seen this. So there's potentially a component of not just synergy from an efficacy standpoint, but even complementary effects to offset toxicities with Ruxolitinib. So it's really a nice marriage or combination of two agents that becomes a tolerable approach to treating myelofibrosis. And again, just for the listeners can appreciate. Ruxolitinib is dosed continuously every day, twice a day. But selinexor is a drug based on its mechanism of action, its pharmacokinetics. It's dosed once a week at 60 milligrams, once a week. These are both oral drugs. So it's an interesting concept because patients may consider that their treatments would be every day and maybe multiple times a day. But the addition of selinexor is really a once a week dosing of a drug with a lot of optimization to make sure that we can address any of these gastrointestinal symptoms. We don't see a lot of myelosuppression, a lot of low blood counts with the combination of these two drugs. we have mechanisms built into the trial that were allowed for dose modifications if a patient is experiencing either hematologic or non-hematologic toxicity. Because the idea is to optimize the dosing both so that the patient has experience that is not one colored by a lot of adverse events, but also that the drug has an opportunity to be effective and active in the disease.

 

Dalton Bean (13:59)

That sounds really exciting. You know, whenever you're talking about combining different agents, the question always goes to, there going to be any overlapping side effects or any, do you expect any increased toxicities? But in what you just said, it sounds like you're not really anticipating to see a ton of adverse effects by combining these two agents.

 

John Mascarenhas, MD (14:19)

Well, you know, we're going to find that out nicely in the phase three, because we'll be able to compare like what is the patient population. And just to point out, it's a two to one randomization. That means that for every two patients that get randomized to selinexor, one patient will be randomized to placebo. But everyone gets the standard of care, ruxolitinib, which is really important to emphasize. No one is missing out on what they would normally get. The real question is, if you get ruxolitinib plus placebo, versus ruxolitinib plus selinexor do we see not just better efficacy but what is the imbalance of toxicity? So we'll be able to compare and say like is there more myelo suppression lowering of the blood counts? Is it clinically relevant? Like does it result in problems or is it just numbers that go down and kind of come up and we can manage those things? So those questions will be answered in the phase three study. We didn't see a signal of lot of overlapping, anticipated overlapping toxicity and again, it might be because of the way these two drugs, actually complement each other very nicely, that there's potentially an offsetting of toxicity that one could see rather than a duplicating of toxicity.

 

Dalton Bean (15:29)

Thank you for highlighting that everyone on this trial will still be receiving ruxolitinib, which is going to be one of your standard of care. So just by signing up for this trial, you're not hurting yourself by missing out on treatment. You're still going to be receiving treatment. It's just, are you receiving the standard treatment or are you receiving the new line, which is hoping to improve upon that treatment? So I feel like we've done a pretty good job highlighting what this study is really looking to evaluate and what these different agents are, but who's eligible for this trial? Who is this designed for?

 

John Mascarenhas, MD (16:02)

So this trial is specifically designed for patients with either primary myelofibrosis or post-ET, post-PV myelofibrosis that meet certain requirements, eligibility criteria that include having a risk score that warrants treatment, which means at least intermediate or high-risk patients. So patients who have low risk disease, maybe patients who don't have any risk variables, these are things that can easily be determined by your treating physician may not be applicable for this, but it really probably applies to the majority of patients with myelofibrosis who have not yet received a JAK inhibitor, and that's the key part. These are JAK inhibitor ruxolitinib namely, but JAK inhibitor naive patients who need treatment. They have a certain degree of spleen enlargement that can be either palpated on exam or measured by imaging and or have a symptom burden that requires improvement. So it's taking patients that would normally standard of care as you've mentioned eligible patients for treatment with the standard care JAKAFI, ruxolitinib. They've been saying, okay, we will either give you that so no one gets nothing and that's really key. Everyone gets what they would normally get but in a two to one fashion adding on the selinexor to these patients who we would normally treat. So these are patients we would normally treat with myelofibrosis that need, that have spleen and symptom burden that are in need of treatment and have a baseline platelet count of at least 100,000. And the reason why, sometimes people say, well, why my platelet count is 80,000? Well, because when we create trials, we want to make sure that we're also being mindful of safety. And we are looking to make sure that we don't have significant drops in platelet counts that could put patients at risk for bleeding complications. So the determination was 100,000 and above would be a safe platelet population to enroll to the study. Now our study is actually ongoing, like the SENTRY two, which is looking at patients with platelet counts between 50,000 and 100,000, where you would get single agent selinexor, and then you would add on ruxolitinib at later time points if certain parameters are met, like the platelet count stays within a certain range, and or you are not attaining maximum benefit with selinexor. So there are alternative studies that are asking, you know, complementary and important questions. But this study is really taking patients who are JAK inhibitor the naive, need treatment because they have spleen and symptom burden and have at least intermediate risk disease and a play the count of 100,000.

 

Dalton Bean (18:39)

And I really like that you've highlighted there that this clinical trial and really all clinical trials are done with patient safety in mind people aren't putting themselves at risk here. These trials are designed to be safe for people to go on to.

 

John Mascarenhas, MD (18:56)

Yeah, I mean,the trials are designed to make sure that we are keeping an eye on safety so that we're seeing issues arise. I personally think, and I know I'm biased, but I personally think that people who participate in clinical trials actually probably have better care and outcomes than patients who don't because there's so much attention by many levels, whether it's the study physician, the research nurse, the clinical research coordinator, the CRO, the sponsor, everyone is looking at the data very carefully. And if we see toxicity whether it's laboratory toxicity or clinical toxicity from patients reporting there are there are very well described directions within the protocol of what to do in terms of you know holding or dose modification or investigation. So safety is top of mind and the other thing I'll just point out because I do think it's important is; you know at least in the case of this drug. This is an approved drug actually. So this is an approved drug that's already gone through the process of phase three testing and FDA evaluation for different malignancies and different hematologic malignancies. So what really we're doing here is taking an approved drug, actually modifying its dosing, lower dosing, and using it in combination with an approved drug in myelofibrosis and asking the question, do these two drugs work better than the single agent JAK inhibitor while maintaining an acceptable safety profile?

 

Dalton Bean (20:18)

So where will this trial be running? We've discussed who's eligible, but where can people actually get onto this trial and how would they go about doing so?

 

John Mascarenhas, MD (20:28)

I mean, the trial is a global trial. It's really being run around the world with many centers in the US. Sometimes patients go to clinicaltrials.gov and they'll go in there and they'll put in myelofibrosis or selenex or a drug of interest and you can see where the studies are being run. You can also just Google on the internet and you can see where the sites may be that are closest to you.

 

And I would even suggest talking to, for those patients with myelofibrosis or their caregivers, even talking to their treating physicians about interest in participating in clinical trials. That's how a lot of patients end up at centers actually, is the patient is the driver of that, maybe initial question or interest and understanding where they can be seen. Karyopharm who runs this trial is doing a very significant outreach to the community and through patient advocacy groups. one such group like the MPN Research Foundation is a great resource for studies in general, but also looking at the SENTRY study and being able to link with folks at either Karyopharm or local institutions to explore further.

 

Dalton Bean (21:39)

And then another question that everyone always seems to have when it comes to clinical trials. Are there going to be any extra costs associated with going on this clinical trial?

 

John Mascarenhas, MD (21:49)

So there shouldn't be. So when you participate in a clinical trial and you're getting standard of care drugs or laboratory tests, that is billed to your insurance company as standard of care normally would. The research drug, is selinexor is provided by the company. Research related questions like doing MRIs of your spleen, looking at different features of the disease that are considered research questions are all paid for by the sponsor.

 

Participating in a study like this should not incur extra costs. And I would also point out to patients, for patients who have to travel in to a center or have to stay in hotel for certain reasons, that the studies often have mechanisms. the patient should ask this question if it's not answered to help with financial support for travel reimbursement or even meals. So there's actually additional support often that's provided to help patients that are participating. Because patients are participating first and foremost because they have a disease and they're looking to improve upon their potential for success and treatment outcome.

 

But also patients are directly and indirectly participating because there's a greater good. When you participate in a study, you're actually helping the research community and the patient community at large understand, are we going in the right direction? So it's really trying to help both yourself and other patients ultimately. And I think that's recognized by the powers that be. to try to help offset any potential for travel costs or food related costs, things that are mundane but important, there are often stipends that are built into that I would definitely urge patients to make sure that they are getting access to that when participating in a study.

 

Dalton Bean (23:48)

Yeah, I've spoken with many people in the past who say that they're interested in clinical trials, but they're worried about the extra costs. So letting people know that one, shouldn't cost you more than the standard of care but there are actual the potential for additional resources. I think that's a really important thing for people to know. You mentioned that they might need some MRIs on their screens, anything like that. Should patients expect to either have to go in for more frequent visits or more frequent testing if they were to take part in this trial?

 

John Mascarenhas, MD (24:20)

Yeah, that's a great question. Typically, yes. So there tends to be, and maybe this relates back to my point about closer observation and safety, actually. There tends to be more observation and follow up, particularly early on when you start a therapy that may be more frequent when you're looking at it like a novel combination of two drugs together. We don't typically, for example, do MRIs as standard of care. So as patients will ask me, is my spleen getting smaller? A standard of care basis, would be measuring it with my hands on an exam. When you participate in a study like this, you actually have an MRI at baseline, and then like three months or six months, and we can actually tell you what percent reduction based on the volume. So there is more follow-up, there's more associated with that follow-up, but I think the payoff is there's probably more attention and safety, and then there's more information actually in terms of the extent and depth of response that we're seeing because of the nature of what that follow-up entails.

 

Dalton Bean (24:58)

I think that sounds really exciting and would be a cool opportunity to be a little bit more closely monitored and get access to some of those tests that you otherwise might not be undergoing for standard of care.

 

So I feel like we've done a pretty good job of highlighting what the study is about, who's it for, what's involved. But I would love to hear from you about what makes you excited about this trial. What gap is this trial looking to fill? you're very heavily involved with this and I'd love to hear why you're excited about this.

 

John Mascarenhas, MD (26:00)

Well, I'm excited about any trial that tries to move the field forward. And this trial in particular is trying to do what other trials have recently been attempting to do, which is the idea of introducing combinations of therapies that are rational early on up front to try to get the deepest response to control the disease and hopefully have that durability of control that ends up being really important.

 

So it's asking an important question is, should we be really using combinations of drugs that are complementary, that don't have overlapping mechanisms of action, the complementary mechanism of action that are relevant to the disease, and then will that ultimately benefit the patient in the long run? And to me, that's what's exciting. And there are other studies to be balanced in this discussion that have or are doing that. So for example,

 

The Transform 1 looking at navidoclax was a study that ultimately failed in its ability to determine an improvement in symptom above ruxolitinib in the upfront JAK inhibitor base, but clearly had a deeper spleen response. And then a drug called pellabrasib in the Manifest 2 demonstrated very significant spleen responses and symptom improvement with a very safe profile, but missed on that P value, that statistical P value for symptom improvement; due to the intrinsic difficulties and challenges in doing that.

 

So this trial is building upon what other studies have looked at and what is, I think, important about understanding selinexor is one of the main mechanisms of action of selinexor is P53, is activation of the P53 pathway, which is really important. So drugs like Navtomatalin, which is an MDM2 inhibitor, which has shown very effective results, both as a single agent in the relapse refractory setting but also in combination is also looking to see if combination therapy is better in a different strategy where they're treating patients upfront with ruxolitinib and then randomizing them at a later time point to either placebo or navtemadlin. So I look at all of this that's going on and as someone who cares for myelofibrosis patient has an invested interest in seeing good drugs move forward that it's really looking at seeing through multiple different attempts how are we best optimizing our patients with combinations of therapies that are relevant? And that to me is a positive step forward. And even when things fail, quote unquote fail, we still learn from our mistakes. A study that fails doesn't mean that every patient on that study failed. It might fail to make an endpoint, but that doesn't mean that patients didn't benefit from the combinations of those studies. I always remind patients of that. We are making progress in everything that we do.

 

As long as we are all on the same page. I'm proud of the way the field is moving and obviously I'd for it to move faster and further, but it is moving. It's moving in the right direction.

 

Dalton Bean (29:01)

It's moving in the right direction and I think everyone in the space is thrilled that it is moving and we all wish it'd be a little bit faster but even that it's moving at all, think everyone's so happy with. I guess just if people were to take away one thing from listening to this podcast, could you just run through who would you encourage to join this trial and why? Just final takeaways here.

 

John Mascarenhas, MD (29:27)

I would encourage everyone to join a trial and people who are eligible, meaning JAK inhibitor naive patients who are interested in the potential for combination therapy to consider this trial. But what I would encourage you to do is speak to your physician about whether you're appropriate for this trial and reach out maybe to trial centers that are running the trial near you to see if this is something for you.

 

And consider it because your participation in a trial is important, potentially for you, potentially for the greater good, and a theme that you and I have hit on multiple times. Participating in these trials does not remove standard of care. That really becomes kind critical in the thought process. It's not asking a question. If we give standard of care versus nothing, what happens? That's not the question being answered. That's an antiquated question.

 

The question that's being answered in this study is, we give standard of care versus standard of care plus something that is rational, do we do better? And the other important part that I always want to stress to a patient is if you get involved in a trial, which in my opinion makes you a trailblazer because you're getting involved in studies that move the field forward and bring treatments to the greater community, but if you move again in a trial, you can always stop. It's not a contract that binds you to the end. One can always stop participating in trial if they're not happy with the results or the interactions or for whatever reason, it doesn't matter. This is to give patients access and to move the field forward, but patients can always stop participating in trial. Sometimes patients don't ask that question, but I think it's in their mind. What if I don't wanna keep doing it or what if something changes in my life? It's okay, that's life, that happens. But being willing and and accepting to even understand what's going on in terms of trials and explore them, I think is an important step. And I give a lot of patients credit that do that too, because it takes a certain degree of courage to move forward with treatment, and this is an example of it. So I thank all the patients that have participated in the trials over the years, because we wouldn't have the standards of care treatments that we have today if those patients didn't pioneer and step forward and participate in those studies.

 

Dalton Bean (31:38)

I think you hit the nail on the head there. The way to move research forward is by participating in trials and that's the way that standard of care is improved is through trial participation. You're never going to lose out on your standard of treatment or at least in this case, you're not losing out on your standard of treatment by participating in this trial. It's really just trying to improve upon that. And I think that's really important for everyone to take home. Well, thank you for joining us today, Dr. Mascaranis. I think this has been really insightful. It sounds like this is an incredible trial and an incredible opportunity for myelofibrosis patients to join if they're eligible.

 

All right, thank you again. Thank you.

 

John Mascarenhas, MD (32:18)

Thanks for having me.

 

Dalton Bean (32:22)

Thank you for joining us for the HealthTree Myelofibrosis Podcast. Join us next time where we'll learn more about how myelofibrosis research is progressing and what that means for you.