Overview1-4
Ponatinib, the only pan-BCR-ABL1 inhibitor, is a third-generation TKI designed to potentially inhibit BCR-ABL1 with or without any single resistance mutation, including T315I
Mechanism of Action1-4
- Ponatinib was designed using a computational structure-based approach to incorporate two key design elements that allow it to confer high potency against both native and mutant BCR-ABL
- Binding of ponatinib to BCR-ABL1 is distributed across multiple sites, which results in high-affinity binding to unmutated BCR-ABL1 and allows it to withstand the loss of binding energy caused by any single mutation
- A carbon-carbon triple bond linkage that allows key interactions with the side chain of the T315I gatekeeper mutant
- In pre-clinical models, ponatinib suppressed all clinically relevant BCR-ABL1 single mutations, including T315I at clinically achievable concentrations
Clinical Trials
Study Name
A Pivotal Phase 1/2, Single-Arm, Open-label Study to Evaluate the Safety and Efficacy of Ponatinib With Chemotherapy in Pediatric Patients With Philadelphia Chromosome-Positive (Ph+) Acute Lymphoblastic Leukemia (ALL) Who Have Relapsed or Are Resistant or Intolerant to a Prior Tyrosine Kinase Inhibitor-Containing Therapy, or Who Have the T315I Mutation
CT.GOV ID
NCT04501614
Phase
Phase 1/2
Status
Active, not Recruiting
View on ClinicalTrials.govStudy Name
A Phase 3, Randomized, Open-label, Multicenter Study Comparing Ponalinib Versus lmatinib, Administered in Combination With Reduced-Intensity Chemotherapy, in Patients With Newly Diagnosed Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia (Ph+ ALL)
CT.GOV ID
NCT03589326
Phase
Phase 3
Status
Recruiting
Study Name
A Randomized, Open-label, Phase 2 Trial of Ponatinib in Patients With Resistant Chronic Phase Chronic Myeloid Leukemia to Characterize the Efficacy and Safety of a Range of Doses (OPTIC)
CT.GOV ID
NCT02467270
Phase
Phase 2
Status
Active, not recruiting
References
1. Clackson T. Design and development of ponatinib, a pan-BCR-ABL inhibitor for CML. Cancer Res. 2013;73(8). Web Link
2. O'Hare T, Shakespeare WC, Zhu X, et al. AP24534, a pan-BCR-ABL inhibitor for chronic myeloid leukemia, potently inhibits the T315I mutant and overcomes mutation-based resistance. Cancer Cell. 2009;16(5):401-412. doi:10.1016/j.ccr.2009.09.028 Iclusig® [package insert]. ARIAD Pharmaceuticals, Inc.
3. Iclusig® [package insert]. ARIAD Pharmaceuticals, Inc.
4. Cortes JE, Kantarjian H, Shah NP, et al. Ponatinib in refractory Philadelphia chromosome-positive leukemias. N Engl J Med. 2012;367(22):2075-2088. doi:10.1056/NEJMoa1205127
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