OncLive® On Air S6 Ep42: Jabbour Highlights New Data With Asciminib and Ponatinib in CML
Apr 28, 2022
Dr. Elias Jabbour, a leading oncologist from MD Anderson Cancer Center, dives deep into chronic myeloid leukemia (CML) advancements. He reveals exciting findings from the ASCEMBL trial showing asciminib's higher efficacy compared to bosutinib. Jabbour discusses ponatinib's optimized dosing strategy and its effectiveness against specific mutations. He highlights the safety profiles of both drugs, emphasizing considerations for patients at high vascular risk. This insightful talk sheds light on the future of CML treatment decisions.
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Asciminib’s Distinct Mechanism And Efficacy
- Asciminib is a STAMP-class allosteric inhibitor that binds the myristoyl pocket and differs mechanistically from ATP-site TKIs.
- In the ASCEMBL trial asciminib (40 mg BID) produced higher MMR at 24 weeks than bosutinib (25% vs 13.2%).
Durability And Tolerability Advantage
- Long-term (48-week) follow-up continued to favor asciminib over bosutinib for response rates.
- Discontinuation due to intolerance was much higher with bosutinib (70%) than asciminib (38%).
Choose Based On Mutation And Vascular Risk
- Consider that asciminib and ponatinib have not been directly compared yet, so choose therapy based on mutation profile and safety.
- Prefer ponatinib for T315I and consider asciminib when vascular risk makes ponatinib less appealing.