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Ponatinib + chemotherapy is a combination regimen consisting of **ponatinib**, a third-generation, orally available small molecule tyrosine kinase inhibitor, and standard chemotherapy agents. Ponatinib acts by inhibiting the BCR-ABL1 tyrosine kinase, including forms with mutations (such as T315I) that confer resistance to first- and second-generation tyrosine kinase inhibitors. The chemotherapy component is typically an alternating regimen involving hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, dexamethasone) and high-dose methotrexate/cytarabine, or other lower-intensity combinations, depending on patient suitability. This combination is approved and used as frontline treatment for adults with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). Ponatinib+chemotherapy has demonstrated superior rates of molecular remission and overall survival versus earlier generation TKIs plus chemotherapy, and is now considered a new standard of care in this indication[1][2][3][4][5].
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