bomedemstat (MK-3543)

P1, N=24, Recruiting, Merck Sharp & Dohme LLC | Trial primary completion date: Nov 2025 --> Mar 2026

P3, N=340, Recruiting, Merck Sharp & Dohme LLC | Trial primary completion date: Sep 2026 --> Jul 2027

P3, N=300, Recruiting, Merck Sharp & Dohme LLC | Trial completion date: Apr 2029 --> Mar 2028

Key trials include the phase 2 LSD1 inhibitor bomedemstat trial showing significant platelet-count reduction and mutation-burden improvement the phase 3 SURPASS-ET trial comparing ropeginterferon alfa-2b versus anagrelide, ongoing investigations of JAK - STAT pathway modulators, and emerging data on the anti-calreticulin (CALR) monoclonal antibody INCA033989, which selectively targets mutCALR progenitors to suppress malignant hematopoiesis while sparing normal hematopoiesis. Drawing on recent clinical trials, expert consensus, and emerging data presented at hematology meetings (2018-2025), we highlight established cytoreductive strategies - hydroxyurea, interferon-α (including pegylated formulations), and anagrelide - and evaluate emerging targeted agents. Future advances in ET management hinge on integrating molecular risk stratification into treatment algorithms, optimizing combination regimens to deepen molecular remissions, and prioritizing agents with favorable safety profiles. Personalized approaches leveraging allele-burden dynamics and symptom-control metrics are likely to define the next era of ET pharmacotherapy.

P3, N=300, Recruiting, Merck Sharp & Dohme LLC | Trial primary completion date: Apr 2027 --> Sep 2027

P2, N=9, Active, not recruiting, The University of Texas Health Science Center at San Antonio | Completed --> Active, not recruiting | Trial completion date: Dec 2023 --> Dec 2026

P1, N=24, Recruiting, Merck Sharp & Dohme LLC | Trial completion date: Dec 2025 --> Mar 2026 | Not yet recruiting --> Recruiting

In PV, ropeginterferon alfa-2b has shown potential disease-modifying effects by reducing the JAK2 V617F allele burden. For ET, treatment remains focused on thrombosis prevention, with hydroxyurea as the mainstay, and novel agents such as pegylated interferon and bomedemstat (LSD1 inhibitor) are also under development. In MF, the evolution of JAK inhibitors is particularly noteworthy, with momelotinib and pacritinib showing potential benefits in alleviating anemia. Additionally, now that HemeSight® is covered by Japanese national health insurance, genetic mutation analysis has become more accessible, paving the way for risk classification based on genetic profiling. This review provides a comprehensive update on the latest risk stratification and therapeutic strategies for MPNs, highlighting emerging treatments and their potential impact on disease management.

P2, N=20, Completed, Imago BioSciences, Inc., a subsidiary of Merck & Co., Inc., (Rahway, New Jersey USA) | Active, not recruiting --> Completed

P1, N=24, Not yet recruiting, Merck Sharp & Dohme LLC

P2, N=9, Completed, The University of Texas Health Science Center at San Antonio | Active, not recruiting --> Completed

P1, N=16, Completed, Merck Sharp & Dohme LLC | Active, not recruiting --> Completed