BCR::ABL1

27 EU-approved indications of 7 drugs need a BCR::ABL1 result, in 2 tumour types, most of them in chronic myeloid leukaemia and acute lymphoblastic leukaemia.

Approved indications27

DrugBiomarker requirementRegimenSettingConditions
Acute lymphoblastic leukaemia8
Sprycel, Dasatinib Accord Healthcare
+ chemotherapy
1L
Children and adolescents only
Glivec
Philadelphia chromosome (bcr-abl)
+ chemotherapy
1L
None
Iclusig
Philadelphia chromosome (BCR::ABL1 translocation)
+ reduced-intensity chemotherapy
1L
None
Sprycel, Dasatinib Accord Healthcare
Monotherapy
2L
Resistance or intolerance to prior therapy
Glivec
Philadelphia chromosome (bcr-abl)
Monotherapy
2L
Relapsed or refractory disease
Iclusig
Philadelphia chromosome (BCR::ABL1 translocation)
Monotherapy
2L
Resistant to dasatinib, or intolerant to dasatinib and subsequent treatment with imatinib is not clinically appropriate
Blincyto
CD19-positive, Philadelphia chromosome-positive
Monotherapy
3L+
B-cell precursor ALL only; Failed treatment with at least 2 tyrosine kinase inhibitors (TKIs); No alternative treatment options
Iclusig
T315I, Philadelphia chromosome-positive
Monotherapy
Any line
None
Chronic myeloid leukaemia19
Bosulif
Philadelphia chromosome / BCR::ABL1 translocation
Monotherapy
1L
Chronic phase only; Aged 6 years and older
Sprycel, Dasatinib Accord Healthcare
Monotherapy
1L
Chronic phase
Sprycel, Dasatinib Accord Healthcare
Monotherapy
1L
Children and adolescents only; Chronic phase
Glivec
Philadelphia chromosome (bcr-abl)
Monotherapy
1L
Bone marrow transplantation is not considered as the first line of treatment
Tasigna
Philadelphia chromosome positive
Monotherapy
1L
Chronic phase
Bosulif
Philadelphia chromosome / BCR::ABL1 translocation
Monotherapy
2L
Chronic phase only; Previously treated with one or more tyrosine kinase inhibitor(s); Aged 6 years and older; imatinib, nilotinib and dasatinib are not considered appropriate treatment options
Bosulif
Philadelphia chromosome / BCR::ABL1 translocation
Monotherapy
2L
Accelerated or blast phase only; Previously treated with one or more tyrosine kinase inhibitor(s); Imatinib, nilotinib and dasatinib are not considered appropriate treatment options
Sprycel, Dasatinib Accord Healthcare
Monotherapy
2L
Resistance or intolerance to prior therapy including imatinib; Chronic, accelerated or blast phase
Sprycel, Dasatinib Accord Healthcare
Monotherapy
2L
Resistance or intolerance to prior therapy; Lymphoid blast phase
Sprycel, Dasatinib Accord Healthcare
Monotherapy
2L
Children and adolescents only; Resistance or intolerance to prior therapy including imatinib; Chronic phase
Tasigna
Philadelphia chromosome positive
Monotherapy
2L
Resistance or intolerance to prior therapy including imatinib; Chronic phase or accelerated phase
Tasigna
Philadelphia chromosome positive
Monotherapy
2L
Children and adolescents only; Resistance or intolerance to prior therapy including imatinib; Chronic phase
Iclusig
Defines the disease
Monotherapy
2L
Resistant to dasatinib or nilotinib, or intolerant to dasatinib or nilotinib and subsequent treatment with imatinib is not clinically appropriate
Iclusig
Defines the disease
Monotherapy
2L
Chronic phase only; Children and adolescents only; Resistant to dasatinib or nilotinib, or intolerant to dasatinib or nilotinib and subsequent treatment with imatinib is not clinically appropriate; Aged 6 years or older
Scemblix
Philadelphia chromosome or BCR-ABL1 fusion
Monotherapy
Any line
Chronic phase only
Scemblix
T315I, Philadelphia chromosome-positive
Monotherapy
Any line
Chronic phase only; Resistant to, intolerant to or ineligible for ponatinib
Glivec
Philadelphia chromosome (bcr-abl)
Monotherapy
Any line
Failure of interferon-alpha therapy (for chronic phase)
Iclusig
T315I
Monotherapy
Any line
None
Iclusig
T315I
Monotherapy
Any line
Chronic phase only; Children and adolescents only; Aged 6 years or older

BCR::ABL1 by tumour

Label wording27

The sentence from section 4.1 of the SmPC that each indication above comes from.

  1. Imatinib (Glivec)
    adult and paediatric patients with newly diagnosed Philadelphia chromosome (bcr-abl) positive (Ph+) chronic myeloid leukaemia (CML) for whom bone marrow transplantation is not considered as the first line of treatment.
  2. Imatinib (Glivec)
    adult and paediatric patients with Ph+ CML in chronic phase after failure of interferon-alpha therapy, or in accelerated phase or blast crisis.
  3. Imatinib (Glivec)
    adult and paediatric patients with newly diagnosed Philadelphia chromosome positive acute lymphoblastic leukaemia (Ph+ ALL) integrated with chemotherapy.
  4. Imatinib (Glivec)
    adult patients with relapsed or refractory Ph+ ALL as monotherapy.
  5. Dasatinib (Sprycel, Dasatinib Accord Healthcare)
    newly diagnosed Philadelphia chromosome positive (Ph+) chronic myelogenous leukaemia (CML) in the chronic phase.
  6. Dasatinib (Sprycel, Dasatinib Accord Healthcare)
    chronic, accelerated or blast phase CML with resistance or intolerance to prior therapy including imatinib.
  7. Dasatinib (Sprycel, Dasatinib Accord Healthcare)
    Ph+ acute lymphoblastic leukaemia (ALL) and lymphoid blast CML with resistance or intolerance to prior therapy.
  8. Dasatinib (Sprycel, Dasatinib Accord Healthcare)
    Ph+ acute lymphoblastic leukaemia (ALL) and lymphoid blast CML with resistance or intolerance to prior therapy.
  9. Dasatinib (Sprycel, Dasatinib Accord Healthcare)
    newly diagnosed Ph+ CML in chronic phase (Ph+ CML-CP) or Ph+ CML-CP resistant or intolerant to prior therapy including imatinib.
  10. Dasatinib (Sprycel, Dasatinib Accord Healthcare)
    newly diagnosed Ph+ CML in chronic phase (Ph+ CML-CP) or Ph+ CML-CP resistant or intolerant to prior therapy including imatinib.
  11. Dasatinib (Sprycel, Dasatinib Accord Healthcare)
    newly diagnosed Ph+ ALL in combination with chemotherapy.
  12. Blinatumomab (Blincyto)
    BLINCYTO is indicated as monotherapy for the treatment of adults with CD19 positive relapsed or refractory B-cell precursor acute lymphoblastic leukaemia (ALL). Patients with Philadelphia chromosome-positive B-cell precursor ALL should have failed treatment with at least 2 tyrosine kinase inhibitors (TKIs) and have no alternative treatment options.
  13. Asciminib (Scemblix)
    Scemblix is indicated for the treatment of adult patients with Philadelphia chromosome-positive chronic myeloid leukaemia in chronic phase (Ph+ CML-CP) (see section 5.1).
  14. Asciminib (Scemblix)
    Scemblix is indicated for the treatment of adult patients with Ph+ CML-CP with the T315I mutation who are resistant to, intolerant to or ineligible for ponatinib (see section 5.1).
  15. Ponatinib (Iclusig)
    chronic phase, accelerated phase, or blast phase chronic myeloid leukaemia (CML) who are resistant to dasatinib or nilotinib; who are intolerant to dasatinib or nilotinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation
  16. Ponatinib (Iclusig)
    chronic phase, accelerated phase, or blast phase chronic myeloid leukaemia (CML) who are resistant to dasatinib or nilotinib; who are intolerant to dasatinib or nilotinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation
  17. Ponatinib (Iclusig)
    Philadelphia chromosome positive acute lymphoblastic leukaemia (Ph+ ALL) who are resistant to dasatinib; who are intolerant to dasatinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation.
  18. Ponatinib (Iclusig)
    Philadelphia chromosome positive acute lymphoblastic leukaemia (Ph+ ALL) who are resistant to dasatinib; who are intolerant to dasatinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation.
  19. Ponatinib (Iclusig)
    Iclusig is indicated in combination with reduced-intensity chemotherapy in adult patients with newly diagnosed Ph+ ALL (see section 5.1).
  20. Ponatinib (Iclusig)
    chronic phase chronic myeloid leukaemia (CP-CML) who are resistant to dasatinib or nilotinib; who are intolerant to dasatinib or nilotinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation.
  21. Ponatinib (Iclusig)
    chronic phase chronic myeloid leukaemia (CP-CML) who are resistant to dasatinib or nilotinib; who are intolerant to dasatinib or nilotinib and for whom subsequent treatment with imatinib is not clinically appropriate; or who have the T315I mutation.
  22. Bosutinib (Bosulif)
    Adult and paediatric patients aged 6 years and older with newly-diagnosed (ND) chronic phase (CP) Philadelphia chromosome-positive chronic myelogenous leukaemia (Ph+ CML).
  23. Bosutinib (Bosulif)
    Adult and paediatric patients aged 6 years and older with CP Ph+ CML previously treated with one or more tyrosine kinase inhibitor(s) [TKI(s)] and for whom imatinib, nilotinib and dasatinib are not considered appropriate treatment options.
  24. Bosutinib (Bosulif)
    Adult patients with accelerated phase (AP), and blast phase (BP) Ph+ CML previously treated with one or more tyrosine kinase inhibitor(s) [TKI(s)] and for whom imatinib, nilotinib and dasatinib are not considered appropriate treatment options.
  25. Nilotinib (Tasigna)
    adult and paediatric patients with newly diagnosed Philadelphia chromosome positive chronic myelogenous leukaemia (CML) in the chronic phase,
  26. Nilotinib (Tasigna)
    adult patients with chronic phase and accelerated phase Philadelphia chromosome positive CML with resistance or intolerance to prior therapy including imatinib. Efficacy data in patients with CML in blast crisis are not available,
  27. Nilotinib (Tasigna)
    paediatric patients with chronic phase Philadelphia chromosome positive CML with resistance or intolerance to prior therapy including imatinib.