Identification, prevention and management of cardiovascular risk in chronic myeloid leukaemia patients candidate to ponatinib: an expert opinion

Massimo Breccia, Patrizia Pregno, Paolo Spallarossa, Eleonora Arboscello, Fabio Ciceri, Mauro Giorgi, Alberto Grossi, Mario Mallardo, Savina Nodari, Stefano Ottolini, Carla Sala, Giovanni Tortorella, Gianantonio Rosti, Fabrizio Pane, Giorgio Minotti, Michele Baccarani

Research output: Contribution to journalArticle

Abstract

Ponatinib (Iclusig, ARIAD Pharmaceuticals-Incyte Co.) is a third-generation structure-guided tyrosine kinase inhibitor that is approved for treatment of Philadelphia chromosome-positive leukaemias resistant or intolerant to other inhibitors. The clinical use of ponatinib is complicated by the possible development of cardiovascular events, primarily hypertension and arterial or venous thrombotic events. The US Food and Drug Administration and the European Medicine Agency recommend that the cardiovascular profile of patients candidate for ponatinib should be carefully evaluated. For patients deemed to carry a high risk of cardiovascular events, other life-saving therapeutic options should be considered. When alternative options are not available, treatment with ponatinib is indicated but requires that haematologists and cardiologists collaborate and identify modalities of surveillance and risk mitigation in the best interest of the patient. This article reports on the expert opinion provided by a panel of Italian haematologists, cardiologists and clinical pharmacologists. It summarises suggestions that may help to improve the therapeutic index of ponatinib, primarily in the settings of chronic-phase chronic myeloid leukaemia.

Original languageEnglish
Pages (from-to)549-558
Number of pages10
JournalAnnals of Hematology
Volume96
Issue number4
DOIs
Publication statusPublished - Sep 30 2016

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Risk Management
Expert Testimony
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukemia, Myeloid, Chronic Phase
Philadelphia Chromosome
United States Food and Drug Administration
Therapeutics
Protein-Tyrosine Kinases
ponatinib
Leukemia
Medicine
Hypertension
Pharmaceutical Preparations

Keywords

  • Journal Article
  • Review

Cite this

Identification, prevention and management of cardiovascular risk in chronic myeloid leukaemia patients candidate to ponatinib : an expert opinion. / Breccia, Massimo; Pregno, Patrizia; Spallarossa, Paolo; Arboscello, Eleonora; Ciceri, Fabio; Giorgi, Mauro; Grossi, Alberto; Mallardo, Mario; Nodari, Savina; Ottolini, Stefano; Sala, Carla; Tortorella, Giovanni; Rosti, Gianantonio; Pane, Fabrizio; Minotti, Giorgio; Baccarani, Michele.

In: Annals of Hematology, Vol. 96, No. 4, 30.09.2016, p. 549-558.

Research output: Contribution to journalArticle

Breccia, M, Pregno, P, Spallarossa, P, Arboscello, E, Ciceri, F, Giorgi, M, Grossi, A, Mallardo, M, Nodari, S, Ottolini, S, Sala, C, Tortorella, G, Rosti, G, Pane, F, Minotti, G & Baccarani, M 2016, 'Identification, prevention and management of cardiovascular risk in chronic myeloid leukaemia patients candidate to ponatinib: an expert opinion', Annals of Hematology, vol. 96, no. 4, pp. 549-558. https://doi.org/10.1007/s00277-016-2820-x
Breccia, Massimo ; Pregno, Patrizia ; Spallarossa, Paolo ; Arboscello, Eleonora ; Ciceri, Fabio ; Giorgi, Mauro ; Grossi, Alberto ; Mallardo, Mario ; Nodari, Savina ; Ottolini, Stefano ; Sala, Carla ; Tortorella, Giovanni ; Rosti, Gianantonio ; Pane, Fabrizio ; Minotti, Giorgio ; Baccarani, Michele. / Identification, prevention and management of cardiovascular risk in chronic myeloid leukaemia patients candidate to ponatinib : an expert opinion. In: Annals of Hematology. 2016 ; Vol. 96, No. 4. pp. 549-558.
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