Dr. Short on the Activity of Ponatinib/Blinatumomab in Ph+ ALL

Nicholas J. Short, MD, assistant professor, Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the efficacy of the combination of ponatinib (Iclusig) and blinatumomab (Blincyto) in Philadelphia chromosome (Ph)–positive acute lymphoblastic leukemia (ALL).

The combination of ponatinib and blinatumomab was evaluated in patients with newly diagnosed and relapsed/refractory Ph-positive ALL. In the phase 2 study (NCT03263572), patients received up to 5 cycles of blinatumomab as a continuous infusion at standard doses. Ponatinib was given at a daily dose of 30 mg during cycle 1, and ponatinib was decreased to 15 mg daily once a complete molecular remission (CMR) was achieved. After patients completed blinatumomab, ponatinib was continued for at least 5 years in responding patients. Twelve doses of prophylactic intrathecal chemotherapy were also administered.

The results of the study, which were presented during the 2021 ASCO Annual Meeting, indicated that 20 patients with newly diagnosed disease have been treated to date and have all shown evidence of response in the absence of subsequent transplant, says Short. The majority of these patients (85%) also achieved a CMR. Moreover, none of the patients who responded to the combination have relapsed, indicating the durability of the regimen, says Short.

This regimen could represent an important chemotherapy-free option for younger and older patients alike and decrease the need for transplant for patients in first remission, concludes Short.