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EHA 2023 | Post hoc analysis of OPTIC: patient responses by T315I mutation status

Jorge Cortes, MD, Augusta University, Augusta, GA, discusses the results of a post hoc analysis of the OPTIC (NCT02467270) trial evaluating patient responses by T315I mutation status. Overall, the study showed that a ponatinib starting dose of 45 mg provided the most benefit to patients regardless of mutation status, but was most pronounced in patients carrying the T315I mutation. This interview took place at the 28th Congress of the European Hematology Association (EHA) 2023 in Frankfurt, Germany.

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Transcript (edited for clarity)

What we’re doing in the OPTIC trial, the OPTIC trial looked at the optimal dose of ponatinib. Patients with at least two prior therapies – two prior TKIs – or with a T315I, and they were randomized to receive 45, 30 or 15mg of the starting dose and then reduce to 15mg once they achieved the 1% or less. So, the post hoc analysis is looking at the mutation status, and what we see is that the patients that have T315I in particular benefit from the 45mg, which is the standard dose – remains the standard dose after this study...

What we’re doing in the OPTIC trial, the OPTIC trial looked at the optimal dose of ponatinib. Patients with at least two prior therapies – two prior TKIs – or with a T315I, and they were randomized to receive 45, 30 or 15mg of the starting dose and then reduce to 15mg once they achieved the 1% or less. So, the post hoc analysis is looking at the mutation status, and what we see is that the patients that have T315I in particular benefit from the 45mg, which is the standard dose – remains the standard dose after this study. But that’s the group that sees the highest magnitude of difference in favor of the 45mg dose. But, it’s important to know that there is also a benefit for patients that have other mutations or even patients who have no mutations. The magnitude of the difference is smaller, but it always favors the 45mg daily dose. So, it is important because we know that T315I seems to require a more intensive therapy, we see that also with asciminib, but also that even in the context of other mutations, giving the optimal dose of ponatinib 45mg gives the best potential benefit to the patients.

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Disclosures

Consultant for Pfizer, Novartis, Takeda, Sun Pharma, Rigel and Forma Therapeutics. Dr Cortes’ institution receives research support from Pfizer, Takeda, Novartis and Sun Pharma.