In a nutshell, the OPTIC trial was a randomized trial testing, different starting doses of ponatinib in patients with advanced CML. And the idea behind this trial, was that, given the toxicity of ponatinib, one would introduce a mandatory dose reduction strategy as soon as patients have had achieved a response. And so, all in all, what the trial as a whole showed is that a reduction strategy that starts with a dose of 45 milligrams, but then goes to 30 and 15 milligrams as patients achieve a complete cytogenetic response is both effective and very safe...
In a nutshell, the OPTIC trial was a randomized trial testing, different starting doses of ponatinib in patients with advanced CML. And the idea behind this trial, was that, given the toxicity of ponatinib, one would introduce a mandatory dose reduction strategy as soon as patients have had achieved a response. And so, all in all, what the trial as a whole showed is that a reduction strategy that starts with a dose of 45 milligrams, but then goes to 30 and 15 milligrams as patients achieve a complete cytogenetic response is both effective and very safe. But it was of interest to see whether the baseline mutation status of the patients influences responses and outcomes. And so, in a nutshell, what the post-hoc analysis shows is that patients who carry a T315I mutation of the BCR-ABL1 kinase require a starting dose of 45 milligrams to have optimal outcomes. Other patients, or patients with other mutations, or without any detectable mutations, they tend to do well with starting dose of 30 milligrams or even 15 milligrams. So in other words, the genotype upfront tells us to some extent what starting dose to use. And I think this will certainly impact clinical practice.
