Official Title
Expanded Access Program of Ponatinib (AP24534) for Patients With Refractory Chronic Myeloid Leukemia or Ph+ Acute Lymphoblastic Leukemia
Brief Summary

This protocol will allow expanded access of ponatinib to patients ≥18 years with chronic myeloid leukemia (CML) any phase or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ALL) who have failed all available treatment options.

Detailed Description

This protocol will allow expanded access of ponatinib to patients ≥18 years with CML or
Ph+ALL who have failed all available treatment options. Patients with chronic (CP) or
accelerated phase (AP) CML must be previously treated with and resistant or intolerant to
imatinib, dasatinib and nilotinib or develop the T315I mutation after any tyrosine kinase
inhibitor (TKI) therapy. Patients with blast phase (BP) CML and Ph+ ALL must be previously
treated with and resistant or intolerant to imatinib and dasatinib or develop the T315I
mutation after any TKI therapy. No formal analysis will be performed on any data obtained.
Safety information will be collected and adverse events will be tabulated for reporting
purposes only.

Approved for marketing
Chronic Myeloid Leukemia (CML)
Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia (Ph+ ALL)

Drug: ponatinib

Patients will receive ponatinib 45 mg orally as a single dose once daily with or without food. Each patient will receive daily ponatinib until disease progression, unacceptable toxicity, or withdrawal of consent
Other Name: AP24534

Eligibility Criteria

Main Inclusion Criteria:

1. CP-CML and AP-CML patients previously treated with and resistant or intolerant to
imatinib, dasatinib and nilotinib or those who developed the T315I mutation after any
TKI therapy. BP-CML and Ph+ ALL patients previously treated with and resistant or
intolerant to imatinib and dasatinib or those who developed the T315I mutation after
any TKI therapy.

2. Patients must be ≥ 18 years old.

3. Provide written informed consent.

4. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.

5. Men and women of childbearing potential must agree to effective contraception from the
time of signing informed consent through the Follow-up Visit, approximately 30 days
after last dose of ponatinib.

Main Exclusion Criteria:

Patients are not eligible for participation in the study if they meet any of the following
exclusion criteria:

1. Are eligible for an ongoing and accessible clinical trial of ponatinib

2. Have not adequately recovered from AEs due to agents previously administered

3. Require concurrent treatment with immunosuppressive agents, other than corticosteroids
prescribed for a short course of therapy.

4. Have previously been treated with ponatinib.

5. Have significant or active cardiovascular disease, specifically including, but not
restricted to:

- Myocardial infarction within 3 months prior to first dose of ponatinib,

- History of clinically significant atrial arrhythmia or any ventricular
arrhythmia,

- Unstable angina within 3 months prior to first dose of ponatinib,

- Congestive heart failure within 3 months prior to first dose of ponatinib.

6. Have abnormal QTcF (> 450 ms for males or > 470 ms for females)

7. Have a significant bleeding disorder unrelated to CML or Ph+ ALL.

8. Have a history of pancreatitis or alcohol abuse

9. Have elevated amylase or lipase (> 1.5 x ULN for institution) at entry.

10. Have inadequate hepatic function or any of the following:

- Total bilirubin > 1.5 x ULN for institution at entry

- Alanine aminotransferase and aspartate aminotransferase > 2.5 x ULN for
institution at entry

- Prothrombin time >1.5 x ULN for institution at entry

11. Have inadequate renal function or serum creatinine > 2.5 x ULN for institution at
entry

12. Have uncontrolled hypertriglyceridemia or triglycerides > 450 mg/dL at entry.

13. Have malabsorption syndrome or other gastrointestinal illness that could affect
absorption of orally administered ponatinib.

14. Women who are pregnant or lactating.

15. Underwent major surgery within 14 days prior to the first dose of ponatinib.

16. Have ongoing or active infection (including known history of human immunodeficiency
virus [HIV], hepatitis B virus [HBV], or hepatitis C virus [HCV]).

17. Suffer from any condition or illness that, in the opinion of the Investigator would
compromise patient safety or interfere with the evaluation of the safety of the study
drug.

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years ~ Maximum: N/A
Countries
United States
Locations

Moores UCSD Cancer Center, Site #165
La Jolla, California, United States

Southern California Permanente Medical Group, Site #161
San Marcos, California, United States

Kaiser Permanente Medical Center, Site #158
Vallejo, California, United States

Smilow Cancer Hospital at Yale New Haven, Site #182
New Haven, Connecticut, United States

Cancer Institute of Florida, Site #187
Altamonte Springs, Florida, United States

H. Lee Moffitt Cancer Center & Research Institute, Site #017
Tampa, Florida, United States

Emory University, Site # 058
Atlanta, Georgia, United States

University of Chicago Medical Center, Site #001
Chicago, Illinois, United States

Indiana Blood and Marrow Transplantation, Site #138
Indianapolis, Indiana, United States

Norton Cancer Institute, Site #142
Louisville, Kentucky, United States

University of Maryland, Site #040
Baltimore, Maryland, United States

Tufts Medical Center, Site #141
Boston, Massachusetts, United States

Dana-Farber Cancer Institute, Site 008
Boston, Massachusetts, United States

University of Massachusetts Worcester, Site #152
Worcester, Massachusetts, United States

University of Michigan Health System, Site #011
Ann Arbor, Michigan, United States

Karmanos Cancer Institute, Site #034
Detroit, Michigan, United States

Mayo Clinic, Site #044
Rochester, Minnesota, United States

Freeman Cancer Institute, Site #190
Joplin, Missouri, United States

Washington University School of Medicine, Site 007
Saint Louis, Missouri, United States

John Theurer Cancer Center at Hackensack University Medical Center, Site 128
Hackensack, New Jersey, United States

Roswell Park Cancer Institute, Site #029
Buffalo, New York, United States

Weill Cornell Medical College - New York Presbyterian Hospital, Site #006
New York, New York, United States

University of Rochester, Site 137
Rochester, New York, United States

Duke University Medical Center, Site 003
Durham, North Carolina, United States

Jewish Hospital, Site #175
Cincinnati, Ohio, United States

Oregon Health & Science University (OHSU), Site 048
Portland, Oregon, United States

Hospital of the University of Pennsylvania, Site #013
Philadelphia, Pennsylvania, United States

Jeanes Hospital of TUHS, Site #127
Philadelphia, Pennsylvania, United States

Medical University of South Carolina, Site #148
Charleston, South Carolina, United States

Tennesse Oncology, PLLC, Site # 076
Nashville, Tennessee, United States

The University of Texas M.D. Anderson Cancer Center, Site #005
Houston, Texas, United States

Huntsman Cancer Institute at the University of Utah, Site #043
Salt Lake City, Utah, United States

Seattle Cancer Care Alliance, Site #100
Seattle, Washington, United States

Ariad Pharmaceuticals
NCT Number
Keywords
Ponatinib
Tyrosine kinase inhibitor
MeSH Terms
Leukemia
Leukemia, Myeloid
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia, Lymphoid
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Philadelphia Chromosome
Ponatinib