First line treatment of T315I mutation in CML management is?: (A) Bosutinib, (B) Tofacitinib, (C) Ponatinib, (D) Nilotinib
Answer is C. T315I mutation is a mutation in the critical BCR-ABL kinase in the ATP-binding pocket This prevents imatinib binding and hence leads to resistance to imatinib, nilotinib, bosutinib, and dasatinib. Only drug effective for T315I mutation CML = Ponatinib. Otherwise DOC CML= Imatinib. DOC for Imatinib resistant CML = Bosutinib DOC in case of failure of > 2 Tyrosine kinase inhibitor = OMACETAXINE