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BCR-ABL fusion gene forms when the ABL gene from chromosome 9 joins to the BCR gene on chromosome 22. BCR-ABL is translated into a constitutively active tyrosine kinase, which is oncogenic. Depending on the fusion location, multiple protein variants are formed with molecular weight ranging from 185 to 210 kDa. BCR-ABL activates JAK/STAT pathway and MAPK signaling. [3] This gene is found in most patients with chronic myelogenous leukemia (CML), and in some patients with acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML).

Ponatinib is the second-generation pan inhibitor of BCR-Abl kinases, which is also effective against the mutant form of BCR-Abl (T315I). [1, 2] IC50 for WT and mutant form are 0.5 and 11 nM. [4] Ponatinib also inhibits several other clinically relevant kinases (RET, FLT3, KIT, PDGFRα, PDGFRβ, and FGFR1) in vitro, with IC50s of 5, 25, 100, 5, 9, and 23) in Ba/F3 cells lines. [4]

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