SOHO 2026 | Insights into the potential of moving towards TKI-sparing strategies in Ph+ ALL

Our approach has also been focusing on blinatumomab and ponatinib. Maybe the only slight difference is that we use a little bit of chemotherapy up front, and once we are in CR1, we’ll go to the consultation with blinatumomab and ponatinib. It does fit really well. I think we have shown, as the oral abstract Abi showed yesterday, that our overall survival has been 100%. And our median follow-up for the patients after TKI discontinuation has been about 30 months. Also importantly, our event-free survival for patients who were treated in the first and second line, a group has been good. I think we only had one patient who had an event. And we defined event, just for clarity, we defined event as patients who either had disease relapse, patients who died from any cause, and patients who had rising MRD based on clonoSEQ that required treatment change. So in the first and second line setting, we really saw that patients did well. That one event that was recorded, patient was re-induced and then went into CMR. And I think this is the part where it is important to realize that our findings really suggest that the first and second line did well compared to the third line plus. And even if we look at those events in the third line plus setting, we were noticing that those events were mostly related to toxicity rather than disease relapse. And for those who purposefully discontinued TKI in that group, meaning the third line plus setting, three of those three patients specifically did not have any events. So we think it is promising. And in terms of like recommendations of when to consider discontinuing TKI, if patients do sustain complete molecular response for two years, I think it is a feasible thing. In the third line plus setting, there has to be a risk-benefit discussion with the patient before making that final decision. I personally believe that we need to do a little bit more work in identifying a molecular signature to suggest or to predict the chances of relapse in these patients, and we’ll be looking at that.