1. Clinical outcomes in patients with Philadelphia chromosome-positive leukemia treated with ponatinib in routine clinical practice-data from a Belgian registry.
- Author
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Devos T, Havelange V, Theunissen K, Meers S, Benghiat FS, Gadisseur A, Vanstraelen G, Vellemans H, Bailly B, Granacher N, Lewalle P, De Becker A, Van Eygen K, Janssen M, Triffet A, Vrelust I, Deeren D, Mazure D, Bekaert J, Beck M, and Selleslag D
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents adverse effects, Belgium, Cardiovascular Diseases chemically induced, Drug Eruptions etiology, Drug Substitution, Female, Follow-Up Studies, Fusion Proteins, bcr-abl antagonists & inhibitors, Humans, Ichthyosis chemically induced, Imidazoles adverse effects, Kaplan-Meier Estimate, Male, Middle Aged, Progression-Free Survival, Prospective Studies, Protein Kinase Inhibitors adverse effects, Pyridazines adverse effects, Registries, Salvage Therapy, Treatment Outcome, Young Adult, Antineoplastic Agents therapeutic use, Imidazoles therapeutic use, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy, Protein Kinase Inhibitors therapeutic use, Pyridazines therapeutic use
- Abstract
Data on clinical use of ponatinib are limited. This prospective registry aimed to evaluate outcomes of ponatinib treatment in routine practice over 3 years (2016-2019) in Belgium (NCT03678454). Patients with chronic myeloid leukemia (CML) or Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) were treated with ponatinib per current label. Fifty patients (33 CML and 17 Ph+ ALL) were enrolled. Fifty-five percent of CML and 29% of Ph+ ALL patients had received ≥3 prior tyrosine kinase inhibitors (TKIs). Reasons for starting ponatinib were intolerance (40%), relapse or refractoriness (28%) to previous TKIs, progression (16%), or T315I mutation (16%). Median follow-up was 15 months for CML and 4.5 months for Ph+ ALL patients. Best response was a major molecular response in 58% of CML and 41% of Ph+ ALL patients. Of 20 patients who started ponatinib due to intolerance to previous TKIs, 9 (64%) CML and 4 (67%) Ph+ ALL achieved a major molecular response. Three-year estimates of overall survival were 85.3% and 85.6%, respectively, in CML and Ph+ ALL patients; estimated progression-free survival was 81.6% and 48.9%. Adverse reactions were reported in 34 patients (68%); rash (26%) and dry skin (10%) were most common. Reported cardiovascular adverse reactions included vascular stenosis (3), arterial hypertension (2), chest pain (1), palpitations (1), and vascular occlusion (1). This Belgian registry confirms results from the PACE clinical trial and supports routine ponatinib use in CML and Ph+ ALL patients who are resistant or intolerant to previous TKIs or with the T315I mutation.
- Published
- 2021
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