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A 62-year-old female patient has been using ponatinib 15 mg for 7 years due to T315I mutation. I have been following her for 5 years in the case of Complete Molecular Response. However, in the last year, the patient has developed hypertensive attacks, stent placement due to carotid artery stenosis, and finally peripheral neuropathy at CTC 2. The patient complains that her quality of life has deteriorated. My question to you is; should I consider switching to asciminib treatment in this patient or should I stop ponatinib treatment for TFR and perform close molecular follow-up. Or should I consider Allogeneic transplantation in a patient with Complete Molecular Response? Thank you in advance for your suggestions. Best regards.
For the patient described below, I would recommend switching to Asciminib 200mg PO BID. Although it is tempting to try TFR, that is not something we typically recommend for patients with T315I on ponatinib. I don’t think the patient needs to proceed to transplant. I think that Asciminib should be a great option.
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