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ESH AL 2026 | The growing armamentarium of agents for older adults with ALL

Marlise Luskin, MD, MSCE, Dana-Farber Cancer Institute, Boston, MA, highlights the expanding treatment options for older adults with acute lymphoblastic leukemia (ALL), including inotuzumab ozogamicin and blinatumomab. She also comments on the potential of venetoclax as an alternative for patients who cannot receive inotuzumab or blinatumomab, and explains that combining available agents to create effective regimens is an ongoing investigative goal. This interview took place at the 5th How to Diagnose and Treat: Acute Leukemias meeting of the European School of Hematology (ESH AL) in Mandelieu-La Napoule, France.

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Transcript

So I think, you know, we’re in a time where we have a lot more tools for older adults than we used to, and so we’re learning how to best use different therapies and different treatment phases. Inotuzumab is an effective, very potent drug, and it has the advantage of being effective for both high and low tumor burden. It’s particularly developed for relapsed leukemia and is now being tested or has now been developed in frontline, both settings where there’s high tumor bulk...

So I think, you know, we’re in a time where we have a lot more tools for older adults than we used to, and so we’re learning how to best use different therapies and different treatment phases. Inotuzumab is an effective, very potent drug, and it has the advantage of being effective for both high and low tumor burden. It’s particularly developed for relapsed leukemia and is now being tested or has now been developed in frontline, both settings where there’s high tumor bulk. Blinatumomab is particularly effective in the setting of low tumor burden, and so that includes remission, consolidation phases, but also MRD, so low levels of disease after induction. The other, you know, things to mention is, you know, venetoclax is an alternative for patients who can’t get Inotuzumab and Blinatumomab, including T-ALL, but it could also potentially be combined with Inotuzumab or chemotherapy, and trying to come up with regimens that use all of our available agents is an investigative goal. And then I think it’s important to message and think about as we close is that we have other therapeutics that are in the early-stage pipeline by a number of both pharmaceutical companies that we hope will have better options that are even more effective and less toxic in the future. And then some agents and strategies, including CAR T-cell, that are approved for relapsed disease, which may be better positioned in the frontline setting for our older patients as a less toxic consolidation strategy for durable remission and maybe even cure.

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Disclosures

Research Funding to Institution: Novartis, AbbVie
Advisory Boards/Consulting: Jazz, Kite, Pfizer, Novartis, AbbVie, KITE, Syndax, Servier, Autolus, Astra Zeneca