Dr. Jabbour on Selecting Ponatinib After Second-Generation TKI Failure in CML

Elias Jabbour, MD, a professor of the Department of Leukemia, of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses selecting ponatinib (Iclusig) after failure of a second-generation TKI in chronic myeloid leukemia (CML).

In the second-line setting, treatment selection for patients with CML may be based on mutational status, explains Jabbour. For example, patients with T315I mutations are eligible to receive ponatinib. Alternatively, dasatinib (Sprycel) should be avoided in patients with F317L mutations, where nilotinib (Tasigna) is preferred, Jabbour says.

Notably, all patients who progress on second-generation TKIs should be considered for ponatinib, irrespective of their T315I mutation status, says Jabbour. The response rates tend to be low when patients are switched to another second-generation TKI versus response rates of greater than 50% with ponatinib, concludes Jabbour.