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Case Reports
. 2021 Mar 3;1(1):19-22.
doi: 10.21873/cdp.10003. eCollection 2021 Mar-Apr.

A Treatment-free Interval Allowed by Ponatinib as Fourth-line Therapy

Anna Bulla  1 , Uros Markovic  1 , Claudia Bellofiore  1 , Stefania Stella  2 , Concetta Conticello  1 , Francesco DI Raimondo  1 , Fabio Stagno  1
Affiliations
Case Reports

A Treatment-free Interval Allowed by Ponatinib as Fourth-line Therapy

Anna Bulla et al. Cancer Diagn Progn. .

Abstract

Background: The third-generation tyrosine kinase inhibitor ponatinib has demonstrated high clinical efficacy in the setting of patients with resistant chronic phase chronic myeloid leukemia (CML), also inducing deep molecular responses. However, ponatinib-related cardiovascular toxicities make management challenging, especially of those patients with CML with previous cardiovascular comorbidities.

Case report: We report on the efficacy of ponatinib treatment used as fourth-line therapy in a 55-year-old woman affected by significant comorbidities (mainly cardiovascular) present before the diagnosis of CML. Ponatinib therapy induced a rapid and excellent clinical response, with the achievement of a durable deep molecular response that allowed us to propose a strategy of treatment discontinuation in order to reduce drug-related toxicities.

Conclusion: A strategy of a treatment-free interval might represent a useful clinical tool in those patients with CML who achieve a durable deep molecular response but are also affected by significant comorbidities in order to minimize the risk of ponatinib-related toxicities.

Keywords: CML therapy; Chronic myeloid leukemia; cardiovascular adverse events; ponatinib; treatment free interval.

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Conflict of interest statement

These Authors declare the following conflict of interest: FS, honoraria by Bristol Myers-Squibb, Incyte, Novartis, Pfizer; FDR, honoraria by Amgen, Bristol Myers-Squibb, Celgene, Incyte, Novartis, Pfizer. All other Authors report no conflicts of interest regarding the article. The Authors alone are responsible for the content and writing of the article.

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