Blinatumomab + TKI for de novo or relapsed Ph+ B-ALL

Results from a single-center, retrospective analysis comparing blinatumomab + tyrosine kinase inhibitors (TKIs) vs pediatric-inspired chemotherapy + TKI protocols in 47 patients with Philadelphia-positive B-cell acute lymphoblastic leukemia (Ph+ B-ALL) were recently published in the International Journal of Cancer by Stolz et al.

Key data: Despite patients in the blinatumomab cohort being significantly older (p < 0.05) and having higher rates of active central nervous system (CNS) disease, overall survival (OS), progression-free survival (PFS), and non-relapse mortality (NRM) were comparable between patients treated with blinatumomab + TKI vs conventional chemotherapy + TKI regimens (2 year-OS, 87% vs 78%; PFS, 81% vs 54%; NRM, 6.3% vs 14%, respectively). Severe treatment-related adverse events (TRAEs) were significantly more common in the chemotherapy group than the blinatumomab cohort. 

Key learning: Blinatumomab + TKI represents a safe and effective chemotherapy-free approach for patients with de novo or relapsed Ph+ B-ALL, offering comparable survival outcomes with significantly reduced treatment-related toxicity compared with standard chemotherapy-based regimens.