Ponatinib- vs Dasatinib-Based Induction in Adults With Newly Diagnosed Ph+ ALL

Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL) outcomes have improved significantly with the incorporation of BCR::ABL1-targeting tyrosine kinase inhibitors (TKIs). Reduced-intensity chemotherapy backbones with potent TKIs are now a preferred treatment approach, particularly for older patients or those with comorbidities. Achieving early, deep molecular responses has emerged as a critical predictor of long-term outcomes and a potential surrogate end point for therapeutic efficacy. Induction with ponatinib plus reduced-intensity chemotherapy has demonstrated high rates of minimal residual disease (MRD)–negative complete remission (CR) (Jabbour et al). However, direct comparative data between ponatinib and second-generation TKIs in the induction setting remain limited.