OncLive® On Air S11 Ep45: Asciminib and Ponatinib Sit at the Forefront of Advances in CML Management: Insights From Onyee Chan, MD; and Bradley D. Hunter, MD
Dec 23, 2024
Join Dr. Onyee Chan, a hematologist-oncologist specializing in myeloid malignancies, and Dr. Bradley D. Hunter, a physician-scientist and medical director, as they dive into the latest advancements in chronic myeloid leukemia (CML) management. They emphasize the importance of integrating asciminib as a first-line therapy and discuss optimal treatment sequencing. Key insights include the impact of the OPTIC trial on ponatinib dosing strategies and the role of mutational testing in personalizing patient care. The dialogue also explores the evolving relevance of stem cell transplantation in treatment.
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Asciminib As Frontline Option
- Use asciminib as first-line therapy for many newly diagnosed chronic-phase CML patients when accessible and tolerable.
- Prioritize potential treatment discontinuation and favorable side-effect profile when selecting asciminib, says Onyee Chan.
Practical Treatment Sequencing
- Sequence therapy: asciminib first, then a second-generation TKI, and consider ponatinib by third line for resistance or intolerance.
- Refer early for transplant evaluation if there is no response or loss of response, recommends Onyee Chan.
Ponatinib Induction Then Lower Maintenance
- For ponatinib, start with a higher induction dose (45 or 30 mg) to achieve rapid response then reduce to 15 mg for maintenance.
- Monitor and individualize starting dose based on fitness and cardiovascular comorbidities, say Bradley D. Hunter and Onyee Chan.