ESH ALL 2021 | Addition of TKIs to chemotherapy when treating Ph-like ALL

Sarah Tasian, MD, The Children’s Hospital of Philadelphia, Philadelphia, PA, gives an overview of clinical trials investigating the addition of tyrosine kinase inhibitors (TKIs) to chemotherapy when treating Philadelphia-like (Ph-like) acute lymphoblastic leukemia (ALL). Ph-like ALL has a very high risk of relapse or end of induction minimal residual disease (MRD) positivity during or after chemotherapy. Dr Tasian suggests that patients with ABL-class Ph-like ALL genomic alterations should be enrolled on clinical trials testing the addition of Src or Src-ABL TKIs, such as dasatinib or imatinib, to backbone chemotherapies. This is due to previous clinical trials reporting improvements in survival and decreases in risk of relapse. Ph-like ALL patients with JAK pathway alterations such as CRLF2 rearrangements have been involved in clinical trials investigating the addition of JAK inhibitors such as ruxolitinib to high-risk chemotherapies. These treatments can potentially result in a reduction of high-risk chemotherapies, which will improve toxicity and remission rates while increasing long-term survival. This interview took place during the 2021 European School of Hematology (ESH) 2nd Translational Research Conference on Acute Lymphoblastic Leukemia.