EHA 2025 | TKIs with blinatumomab versus chemotherapy in Ph+ ALL: a single-center retrospective analysis
Max Rieger, MD, University Hospital Zurich, Zurich, Switzerland, discusses the shift in the treatment landscape for Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), highlighting the improved response rates and reduced toxicity observed when treating patients with blinatumomab plus tyrosine kinase inhibitors (TKIs) over traditional chemotherapy approaches. Dr Rieger notes that a single-center retrospective analysis conducted at his institution confirmed this superior safety and efficacy of TKIs plus blinatumomab, with lower non-relapse mortality, higher remission rates, and improved long-term survival. This interview took place at the 30th Congress of the European Hematology Association (EHA) in Milan, Italy.
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Transcript
So a couple of years ago with the publication of actually two quite pivotal Phase III studies, the treatment landscape in Philadelphia positive B-cell acute lymphoblastic leukemia has changed. It used to be that all those patients were receiving quite intensive chemotherapy and tyrosine kinase inhibitor (TKI) protocols. They now more and more receive only blinatumomab and TKI, which led to quite sensational response rates but also reduced toxicity, which used to be a major issue with the previous treatment...
So a couple of years ago with the publication of actually two quite pivotal Phase III studies, the treatment landscape in Philadelphia positive B-cell acute lymphoblastic leukemia has changed. It used to be that all those patients were receiving quite intensive chemotherapy and tyrosine kinase inhibitor (TKI) protocols. They now more and more receive only blinatumomab and TKI, which led to quite sensational response rates but also reduced toxicity, which used to be a major issue with the previous treatment. And in our study that we just published, we could actually compare our own patients who were treated with TKI and blinatumomab to our historic cohort with patients receiving this traditional gold standard of pediatric-inspired chemotherapy and TKI. And we were actually able to confirm those results that have been shown by the Phase II studies that not only were side effects lower, way lower, that led to a lower rate of non-relapse mortality but also was the effectiveness actually higher than what it used to be with chemotherapy and this is remarkable. And we could see that in hematologic remission rate, we could see that in MRD-negativity, and we can see that in long-term survival. And I really hope that we can keep translating this approach into clinical practice in many sites in the world and actually improving patient care.
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