SOHO 2024 | The incorporation of immunotherapy into frontline ALL treatment

Well, this is an emerging area that is showing great interest using immunotherapeutic agents, including blinatumomab, a bispecific T-cell engager molecule, and also inotuzumab ozogamicin, an antibody-drug conjugate that brings a CD22 antibody link to calicheamicin, a DNA damaging agent. So these have been shown to be of benefit in relapsed/refractory acute lymphoblastic leukemia and show great efficacy there. And now there are increasing studies that are showing the benefit of using these agents in upfront treatment. Initially, they have been combined with chemotherapy incorporated into the chemotherapy regimens and showed increased response rates and improved outcomes. There are now some studies, small studies using these agents by themselves, particularly in older individuals, either as initial upfront therapy and then followed by chemotherapy, or again using them in sequence by themselves as a study with inotuzumab and blinatumomab. And those are showing high response rates in older individuals, who typically have a poor prognosis with acute lymphoblastic leukemia, and showing promising results. Further study is needed with these agents to expand the number of patients that are treated and give us a better sense of how they can be incorporated and shown to be of benefit. But it’s a very exciting area, and it brings the hope that we can give less chemotherapy to patients and rely on these agents, which tend to be better tolerated. So reduce some of the side effects and the deaths from complications of the treatment.