SOHO 2026 | Reshaping frontline Ph+ ALL: third-generation TKI plus immunotherapy
Josep-Maria Ribera, MD, PhD, Germans Trias i Pujol University Hospital, Barcelona, Spain, discusses the potential of third-generation tyrosine kinase inhibitor (TKI) and immunotherapy combinations to reshape frontline treatment for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). Prof. Ribera highlights how this chemotherapy-free approach may reduce the need for allogeneic stem cell transplantation (alloSCT). He also discusses the promising results of the Phase III GIMEMA ALL2820 trial (NCT04722848) in patients with newly diagnosed Ph+ ALL. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
The traditional combination of chemotherapy, TKI, followed by allogeneic stem cell transplantation, applies for first-generation, first- or second-generation TKIs. Now, currently, we are using third-generation TKI, that means ponatinib up to now and when possible we use immunotherapy, blinatumomab, in these cases we can avoid transplantation in many patients but if we cannot use this modern combination and we still are using imatinib or dasatinib plus attenuated chemotherapy we need allogeneic transplantation in most patients especially those who do not achieve complete molecular response...
The traditional combination of chemotherapy, TKI, followed by allogeneic stem cell transplantation, applies for first-generation, first- or second-generation TKIs. Now, currently, we are using third-generation TKI, that means ponatinib up to now and when possible we use immunotherapy, blinatumomab, in these cases we can avoid transplantation in many patients but if we cannot use this modern combination and we still are using imatinib or dasatinib plus attenuated chemotherapy we need allogeneic transplantation in most patients especially those who do not achieve complete molecular response. Well now I think that we have to reshape clearly the front-line treatment of Ph-positive ALL given the results of Phase II trials and the recently completed Phase III trial that clearly demonstrates that the combination of third generation TKI plus blinatumomab has achieved the best therapy results to date in Ph-positive ALL. I think that this is the way that we have to treat modern treatment of Ph-positive ALL. And I guess that the regulatory agencies such as FDA, EMA, will approve this combination soon for newly diagnosed patients with Ph-positive ALL.
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