PhALLCON
Head to head, the third-generation TKI ponatinib doubled the rate of deep, undetectable remission over imatinib in newly diagnosed Ph-positive ALL.
MRD-negative CR at end of induction 34.4% vs 16.7% (risk difference 0.18, p=0.002); fewer treatment failures; arterial occlusive events comparable at the reduced 30→15 mg dosing. JAMA 2024. Accelerated approval March 2024; the first randomised TKI comparison in frontline Ph+ ALL.
- 34.4 vs 16.7 out of 100 had no detectable disease on sensitive tests with Ponatinib + chemotherapy compared with Imatinib + chemotherapy; 17.7 more per 100.
- Roughly one extra person helped for every 6 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- The p-value (0.002) says a difference this large would rarely happen by chance; it does not say how large or how useful the difference is.
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- These results apply to the people the trial enrolled: Newly diagnosed Ph-positive ALL, adults: ponatinib vs imatinib, each with reduced-intensity chemotherapy. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
245 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| MRD-negative complete remission at end of inductionprimary | Ponatinib + chemotherapy | 164 | 34.4% | — | 0.002 | link |
| Imatinib + chemotherapy | 81 | 16.7% |
Pages like this
not linked directly; found by shared links- TrialD-ALBA (GIMEMA LAL2116)
Shares BCR::ABL1 TKI + blinatumomab (chemotherapy-free Ph+ ALL), Ph-positive ALL, BCR::ABL1 (Philadelphia chromosome), Acute lymphoblastic leukaemia.
- IdeaTransplant-free Ph-positive ALL for MRD-negative adults
Shares Ponatinib, Ph-positive ALL, MRD-negative complete remission, Acute lymphoblastic leukaemia.
- ProductDasatinib
Shares BCR::ABL1 TKI + blinatumomab (chemotherapy-free Ph+ ALL), Ph-positive ALL, BCR::ABL1 (Philadelphia chromosome), Acute lymphoblastic leukaemia.
- ProductAsciminib
Shares Ph-positive ALL, BCR::ABL1 (Philadelphia chromosome), Acute lymphoblastic leukaemia.
- TermPhiladelphia chromosome (Ph+, BCR::ABL1)
Shares Ponatinib, Imatinib, Acute lymphoblastic leukaemia.
- Key paperFirst imatinib trial: a pill that switched off the enzyme driving chronic myeloid leukaemia
- PersonBud Romine
- PersonOwen N. Witte