While no JAK inhibitor has demonstrated clear disease-modifying effects in MF, pacritinib's non-myelosuppressive profile, unique activity against IRAK1, and potential anemia benefit via ACVR1 inhibition suggests potential utility as a backbone for future combination strategies. Ongoing and future studies will be critical to further define its role in phenotype-driven MF management.

P1/2, N=160, Recruiting, National Cancer Institute (NCI) | Not yet recruiting --> Recruiting

P2, N=78, Recruiting, Swedish Orphan Biovitrum | Active, not recruiting --> Recruiting

P2, N=27, Recruiting, University of Washington | Not yet recruiting --> Recruiting

P1/2, N=25, Not yet recruiting, Thomas Jefferson University

P2, N=78, Active, not recruiting, Swedish Orphan Biovitrum | Trial completion date: Aug 2027 --> May 2028 | Trial primary completion date: Aug 2027 --> Dec 2026

P2, N=78, Active, not recruiting, Swedish Orphan Biovitrum | Recruiting --> Active, not recruiting

He was started on JAK inhibitor therapy with pacritinib but clinically declined over the next several days with worsening diffuse pain and pancytopenia...Shortly after, the patient presented to an outside hospital with septic shock, at which point the patient expired. This case illustrates the aggressive nature of the disease, the need for confirmatory testing when diagnosis is suspected and the difficulty in management as the prognosis is poor and requires aggressive treatment that can lead to life-threatening sequelae.

P2, N=32, Not yet recruiting, Medical College of Wisconsin

Adverse events, including gastrointestinal symptoms, weight loss, and transient voice changes, were manageable through dose adjustments and supportive care, enabling continued therapy. Our cases contribute to the growing body of evidence supporting pacritinib's role in the evolving treatment landscape of MF.

Notably, we found that gastric cancer cells display marked sensitivity to IRAK1/4 inhibitor and pacritinib, the latter targeting JAK2 and IRAK1 specifically, over the pan-JAK inhibitor tofacitinib. Collectively, our results underscore IRAK1 as a promising therapeutic target in gastric cancer. Furthermore, the pharmacological blockade of IRAK1 by pacritinib, an established drug for myelofibrosis and severe thrombocytopenia treatment, holds potential for repurposing in gastric cancer therapy.