Case report: Ponatinib as a bridge to CAR-T cells and subsequent maintenance in a patient with relapsed/refractory Philadelphia-like acute lymphoblastic leukemia

Philadelphia (Ph)-like acute lymphoblastic leukemia (ALL) constitutes a heterogeneous subset of ALL with a uniformly unfavorable prognosis. The identification of mutations amenable to treatment with tyrosine kinase-inhibitors (TKIs) represents a promising field of investigation. We report the case of a young patient affected by relapsed/refractory Ph-like ALL treated with chimeric antigen receptor T (CAR-T) cells after successful bridging with compassionate-use ponatinib and low-dose prednisone. We restarted low-dose ponatinib maintenance three months later. Twenty months later, measurable residual disease negativity and B-cell aplasia persist. To the best of our knowledge, this is the first case reporting the use of ponatinib in Ph-like ALL as a bridge to and maintenance after CAR-T cell therapy.

 

Comments：

In a case of relapsed/refractory Ph-like ALL, the patient was treated with CAR-T cells after successful bridging with compassionate-use ponatinib and low-dose prednisone, with ponatinib maintenance resumed three months later resulting in measurable residual disease negativity and B-cell aplasia that persists 20 months later, making it the first reported use of ponatinib in Ph-like ALL as a bridge to and maintenance after CAR-T cell therapy.

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Cat.No.	Product Name	Information
S1490	Ponatinib	Ponatinib is a novel, potent multi-target inhibitor of Abl, PDGFRα, VEGFR2, FGFR1 and Src with IC50 of 0.37 nM, 1.1 nM, 1.5 nM, 2.2 nM and 5.4 nM in cell-free assays, respectively. Ponatinib (AP24534) inhibits autophagy.

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Bcr-Abl Autophagy FGFR Src PDGFR VEGFR