Ponatinib

Ponatinib (Iclusig, Incyte Biosciences Distribution B.V.) has 7 EU-approved indications in 2 tumour types. Each needs a biomarker result: BCR::ABL1 (7).
Approved indications of Ponatinib
Biomarker requirementRegimenSettingConditions
Acute lymphoblastic leukaemia3
Philadelphia chromosome (BCR::ABL1 translocation)
+ reduced-intensity chemotherapy
1L
None
Philadelphia chromosome (BCR::ABL1 translocation)
Monotherapy
2L
Resistant to dasatinib, or intolerant to dasatinib and subsequent treatment with imatinib is not clinically appropriate
T315I, Philadelphia chromosome-positive
Monotherapy
Any line
None
Chronic myeloid leukaemia4
BCR::ABL1 fusion (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
BCR::ABL1 fusion (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
BCR::ABL1 T315I
Monotherapy
Any line
None
BCR::ABL1 T315I
Monotherapy
Any line
Chronic phase only; Children and adolescents only; Aged 6 years or older
Full text of section 4.1 (therapeutic indications)

Iclusig is indicated as monotherapy in adult patients with • 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 • 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. Iclusig is indicated in combination with reduced-intensity chemotherapy in adult patients with newly diagnosed Ph+ ALL (see section 5.1). Iclusig is indicated as monotherapy in paediatric patients 6 years of age or older with • 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. See sections 4.2 for the assessment of cardiovascular status prior to start of therapy and 4.4 for situations where an alternative treatment may be considered.

Label history

43 changes to the Iclusig label since 2013, 2 of them to the indications. Newest first, in the words of EMA's record of each procedure.

Changes