BCR-ABL1 T315I is the gatekeeper mutation conferring pan-resistance to imatinib, dasatini...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-BCR-ABL1-T315I-CML |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-CML |
| Sources | SRC-CIVIC SRC-ELN-CML-2025 SRC-PACE-CORTES-2013 |
Actionability Facts
| Biomarker | BIO-BCR-ABL1 |
|---|---|
| Variant | T315I (gatekeeper resistance) |
| Disease | DIS-CML |
| ESCAT tier | IA |
| Recommended combinations | ponatinib monotherapy, asciminib monotherapy (200 mg BID for T315I) |
| Contraindicated monotherapy | imatinib (resistant), dasatinib (resistant), nilotinib (resistant), bosutinib (resistant) |
| Evidence summary | BCR-ABL1 T315I is the gatekeeper mutation conferring pan-resistance to imatinib, dasatinib, nilotinib, and bosutinib. Ponatinib (PACE, Cortes 2013) is approved for T315I+ CML. Asciminib (allosteric STAMP inhibitor) at higher dose (200 mg BID) also has T315I activity per ASCEMBL extension and dedicated cohorts. Allo-HCT remains a salvage option in eligible patients. |
Notes
OncoKB R1. ABL1 kinase domain mutation testing mandatory at TKI failure or warning per ELN. Ponatinib cardiovascular risk requires dose-optimization (OPTIC trial, Cortes 2021).
Used By
No reverse references found in the YAML corpus.