Asciminib May Be an “Attractive” Option in Newly Diagnosed CML Populations


Ongoing genomic profiling analyses in the ASC4FIRST trial may further determine which patients with CML may benefit from treatment with asciminib.

Asciminib (Scemblix) may be an “attractive” treatment option for patients with chronic myeloid leukemia (CML) who are typically candidates for other therapies such as imatinib (Glivec), according to Timothy P. Hughes, MD, FRACP, FRCPA, MBBS, FAAHMS.

In a conversation with CancerNetwork® during the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting, Hughes, a professor and faculty at the Health and Medical Sciences of The University of Adelaide Medical School in Australia, spoke about patients with newly diagnosed CML who may benefit from treatment with asciminib based on findings from the phase 3 ASC4FIRST trial (NCT04971226). According to Hughes, asciminib may offer improved potency as well as equivalent safety compared with options such as imatinib.

Hughes also highlighted that the next steps for researching asciminib in this population will involve genomic profiling analyses, which may help further determine the types of patients who can benefit most from this treatment.


When you’re [considering asciminib for] a patient for whom you would normally select imatinib, that suggests you’re worried about toxicity. A patient may have comorbidities and frailty. Given this new finding, you can use the asciminib, which is far more potent and has equivalent or better safety [compared with imatinib]. That provides an attractive option for those patients. For the patients where you would select a second-generation drug, we now have a drug that is equally potent but clearly safer, so that becomes a good opportunity there, as well.

One of the things we’re [researching] at the moment is the genomic profile of that diagnosis and whether that can guide our therapy. We’re going to see the results of that profiling from the ASC4FIRST study over the next 6 months. [The results] will tell us a lot more about who’s benefiting the most from asciminib and where we might need to use a different approach. That’s going to be very important.


Hughes TP, Hochhaus A, Takahashi N, et al. ASC4FIRST, a pivotal phase 3 study of asciminib (ASC) vs investigator-selected tyrosine kinase inhibitors (IS TKIs) in newly diagnosed patients (pts) with chronic myeloid leukemia (CML): primary results. J Clin Oncol. 2024;42(suppl 17):LBA6500. doi:10.1200/JCO.2024.42.17suppl.LBA6500

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