Venetoclax-ponatinib for T315I/compound-mutated Ph+ acute lymphoblastic leukemia

Wang, Huafeng; Yang, Chang; Shi, Ting; Zhang, Yi; Qian, Jinwen; Wang, Yungui; Hu, Yongxian; Mao, Liping; Ye, Xiujin; Liu, Fang; Xi, Zhenfang; Shou, Lihong; Fu, Caiyun; Naranmandura, Hua; Jin, Jie; Zhu, Hong‐Hu

doi:10.1038/s41408-022-00621-9

Cited by 22 publications

(14 citation statements)

References 13 publications

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“…With respect to ponatinib, we did not identify any case reports of TLS, however, we did find two cohort studies that reported on TLS occurrence in patients with ALL. 36,37 Only one case nonfatal of TLS was reported (8%), wherein 13 patients received multitherapy HyperCVAD and ponatinib. 36 These patients were not given TLS prophylaxis.…”

Section: Dasatinibmentioning

confidence: 99%

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Tyrosine kinase inhibitors and tumor lysis syndrome in hematologic malignancies: A systemic review

Salter

Burns

Fuller

et al. 2022

European J of Haematology

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Background Effective treatments for hematologic malignancies include therapies that target tyrosine kinase (TK) signaling pathways. Tumor lysis syndrome (TLS) is an oncologic emergency that can occur due to rapid turnover following the initiation of treatments for hematologic malignancy. The incidence of TLS is under‐reported and it is unclear as to whether TK inhibitors (TKIs) are associated with TLS. Objective To conduct a systematic review to determine the incidence of TLS with TKIs. Methods A search was performed using EMBASE, MEDLINE, and Web of Science electronic databases, as well as a manual search of the American Society of Hematology and American Society of Clinical Oncology abstract databases. Keywords included: “tumor lysis syndrome,” “tyrosine kinase inhibitors,” “lymphoma,” and “leukemia.” Results We identified a total of 57 publications that commented on the incidence of TLS with TKIs for hematologic malignancy. Thirty‐nine of those publications reported TLS as an adverse event. TLS was described as an adverse event among essentially all the subclasses of TKIs that are used to manage hematologic malignancies. Conclusion The overall number of articles commenting on TLS as an adverse event is sparse and there needs to be more transparency regarding the incidence of TLS when employing newer targeted therapies. Physicians should consider the risk of TLS on an individual basis and the added risk of TLS when using TKIs to treat hematologic malignancy.

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Section: Dasatinibmentioning

confidence: 99%

“…36,37 Only one case nonfatal of TLS was reported (8%), wherein 13 patients received multitherapy HyperCVAD and ponatinib. 36 These patients were not given TLS prophylaxis. We found one phase I clinical trial that assessed bafetinib monotherapy in patients with Ph + leukemia, with doses ranging from 30 mg daily to 480 mg twice daily.…”

Section: Dasatinibmentioning

confidence: 99%

Tyrosine kinase inhibitors and tumor lysis syndrome in hematologic malignancies: A systemic review

Salter

Burns

Fuller

et al. 2022

European J of Haematology

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“…Ponatinib was only given after allo-HSCT if positive measurable residual disease (MRD) persisted or reappeared. Thirty patients (median age 49 [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ] years) entered the trial. All patients showed CHR, and allo-HSCT was performed on 26 patients (20 in CMR and 6 in MMR).…”

Section: Ponatinib In First Line Therapymentioning

confidence: 99%

“…Currently, only tisagenlecleucel has been licensed for treatment of R/R ALL up to the age of 25 years and the use of bretxucabtagene autoleucel was licensed by the FDA in October 2021 for R/R ALL patients [ 52 ], but many phase 2 trials with CAR T are ongoing. However, it is recommendable, when possible, to include R/R Ph+ ALL patients in clinical trials including TKI, immunotherapies, and other targeted therapies [ 12 , 53 , 54 , 55 ] (see below).…”

Section: Management Of Relapsementioning

confidence: 99%

“…Clinical experience of this combination is limited. An open label, phase 1/2 study of the combination of ponatinib, venetoclax, and dexamethasone for adult patients with relapsed or refractory Ph+ ALL is being conducted at MDACC [ 55 ]. In the phase 1 part of the trial two dose levels of venetoclax were investigated (400 mg and 800 mg daily).…”

Section: Other Targeted Therapiesmentioning

confidence: 99%

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Modern Management Options for Ph+ ALL

Ribera

Chiaretti

2022

Cancers

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Impressive advances have been achieved in the management of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) since the initial concurrent use of imatinib and standard chemotherapy. The attenuation of chemotherapy has proven to be equally effective and less toxic, the use of third generation TKI upfront has improved the frequency of complete molecular response and the survival rate, and the combination of tyrosine kinase inhibitors with immunotherapy has further increased the rate of molecular response to 70–80% after consolidation, which has been translated into a survival rate of 75–90% in recent trials. As a result of these improvements, the role of allogeneic hematopoietic stem cell transplantation is being redefined. The methodology of measurable residual disease assessment and the detection of ABL1 mutations are also improving and will contribute to a more precise selection of the treatment for newly diagnosed and relapsed or refractory (R/R) patients. Finally, new compounds combined with immunotherapeutic approaches, including cellular therapy, are being used as rescue therapy and will hopefully be included in first line therapy in the near future. This article will review and update the modern management of patients with Ph+ ALL.

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A new chemotherapy‐free regimen of olverembatinib in combination with venetoclax and dexamethasone for newly diagnosed Ph+ acute lymphoblastic leukemia: Preliminary outcomes of a prospective study

Tang,

Jia,

Jia

et al. 2024

American J Hematol

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Venetoclax-ponatinib for T315I/compound-mutated Ph+ acute lymphoblastic leukemia

Cited by 22 publications

References 13 publications

Tyrosine kinase inhibitors and tumor lysis syndrome in hematologic malignancies: A systemic review

Tyrosine kinase inhibitors and tumor lysis syndrome in hematologic malignancies: A systemic review

Modern Management Options for Ph+ ALL

A new chemotherapy‐free regimen of olverembatinib in combination with venetoclax and dexamethasone for newly diagnosed Ph+ acute lymphoblastic leukemia: Preliminary outcomes of a prospective study

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