Multinational phase 3 trial comparing ponatinib versus imatinib for newly diagnosed Ph+ALL: first results of PhALLCON

The standard of care in patients with newly diagnosed Philadelphia chromosome positive (Ph+) ALL is BCR::ABL1 TKIs in combination with chemotherapy or steroids. Treated with 1st- or 2nd-generation TKIs, patients eventually progress due to emergence of resistance. The multinational phase 3 PhALLCON trial compared the 3rd-generation TKI ponatibinib versus the 1st-generation TKI imatinib, both in combination with reduced-intensity chemotherapy, for newly diagnosed Ph+ALL. First results of the trial showed a significantly higher MRD-negative complete remission rate with ponatinib versus imatinib at end of induction. Ponatinib was associated with deeper and more durable responses, with a trend toward improved EFS (not yet mature) and comparable safety versus imatinib.