Ponatinib treatment in a real-world cohort of CML patients yielded a 5-year overall survival of 76% (vs 73% in the PACE trial) and a 23.1% rate of cardiovascular adverse events.
Cohort (n=78)
No
What is the incidence of cardiovascular adverse events and survival outcomes in patients with chronic myeloid leukemia treated with ponatinib in a real-world setting?
In a real-world cohort of CML patients treated with ponatinib, cardiovascular adverse events occurred in 23.1%, but dose adjustments and cardio-oncology referral were associated with decreased toxicity.
Absolute Event Rate: 76% vs 73%
Ponatinib is associated with cardiovascular adverse events (CAEs), and its frequency in the real world is limited. In this retrospective study, we examined the survival outcomes and associated toxicities in 78 consecutive ponatinib-treated patients with chronic myeloid leukemia (CML) at the Moffitt Cancer Center from January 2011 through December 2017. The most common non-CAE was thrombocytopenia (39.7%), occurring in a dose-dependent fashion. Eighteen patients (23.1%) experienced some form of CAE, with the most common being arrhythmia (9%) and hypertension (7.7%), whereas 3 patients experienced myocardial infarction (3.8%). Before 2014, most patients were started on ponatinib 45 mg daily. There was an inverse correlation between cardio-oncology referral and the number of CAEs (P = .0440); however, a lower ponatinib starting dose, more frequent dose reduction, and increased cardio-oncology referral all were likely to have contributed to the observed decrease in CAEs after 2014. The response rate and 5-year overall survival (OS) were higher than those observed in the Ponatinib Ph+ ALL and CML Evaluation (PACE) trial (major molecular response, 58.7% vs 40% and OS, 76% vs 73%; median follow-up of 32.5 months). Ponatinib-treated patients with chronic phase-CML did not show a significant improvement with allogeneic stem cell transplantation, whereas those with accelerated phase/blast phase-CML had a much better outcome (median OS of 32.9 months vs 9.2 months; P = .01). These results demonstrate that ponatinib is highly effective. Dose adjustments and increased awareness of the cardiotoxicities associated with ponatinib may help maximize its benefits.
Chan et al. (Tue,) conducted a cohort in Chronic myeloid leukemia (CML) (n=78). Ponatinib vs. Historical PACE trial cohort was evaluated on 5-year overall survival (OS). Ponatinib treatment in a real-world cohort of CML patients yielded a 5-year overall survival of 76% (vs 73% in the PACE trial) and a 23.1% rate of cardiovascular adverse events.