Dr Fleur-Lominy on Ongoing Research Within CML at the 2024 ASCO Annual Meeting

Shella Saint Fleur-Lominy, MD, PhD, assistant professor, Department of Medicine, program director, Hematology and Medical Oncology Fellowship, New York University Grossman School of Medicine, and Yan Leyfman, MD, internal medicine and clinical researcher, Mount Sinai, co-founder, executive director, MedNews Week, executive committee member, Music Beats Cancer, discuss ongoing research within the chronic myeloid leukemia (CML) patient population on OncLive® News Network: On Location at the 2024 ASCO Annual Meeting.

Leyfman says that at the meeting, attendees saw exciting data from a late-breaking off-track presentation on the use of asciminib (Scemblix) compared with investigator-selected TKIs in patients with newly diagnosed CML, as seen in the phase 3 ASC4FIRST trial (NCT04971226). These results are exciting, Fleur-Lominy begins. The study met its primary end point, which is quite rare for a phase 3 study, Fleur-Lominy reports. Achievement of major molecular response (MMR) is particularly important for young patients, as achieving early, deep remissions means they may not need lifelong treatment, Fleur-Lominy notes. The ability to reach MMR early with asciminib is promising, and the biggest beneficiaries will be the patients receiving this agent, she explains.

Within CML, there is also a 4-year follow-up analysis of the phase 2 OPTIC trial (NCT02467270), which includes ponatinib in patients with chronic-phase CML harboring a BCR::ABL1 T315I mutation, Leyfman shares. Fleur-Lominy shares that these data are not surprising, as patients with BCR::ABL1 T315I mutations are resistant to first- and second-generation TKIs, leaving few treatment options. However, ponatinib (Iclusig) has been shown to be effective in this patient population, Fleur-Lominy notes. This study compared different doses of ponatinib in a 1:1:1 randomization, showing that patients who receive this agent can remain in long-term remission with good overall survival outcomes, she shares. The 45 mg dose of ponatinib was the most effective, though it was also associated with more toxicity than the other dose levels. However, patients who lost their response on a lower dose could still be salvaged by re-escalating to a higher dose, Fleur-Lominy concludes.