Ponatinib-Blinatumomab or Imatinib-Chemotherapy for Adult Ph-Positive ALL.

What was studied

This late-stage trial tested a first-line plan in adults with Ph-positive acute lymphoblastic leukemia. The new plan was ponatinib plus blinatumomab, with no chemotherapy. The standard plan was imatinib plus chemotherapy. 236 people were assigned at random. 158 got the new plan and 78 got the standard one. A switch to the new plan was allowed if leftover disease persisted or returned. The main goal was event-free survival.

What they found

At 24 months, event-free survival was higher with the new plan. Survival with no measurable residual disease was also higher. A complete blood response after induction was more common with the new plan. A molecular response after blinatumomab was also more common. After the switch, 20 of 31 people had a molecular response. Overall survival was higher and relapse lower with the new plan.

What it means for patients

The authors say a chemotherapy-free targeted and immune approach was superior to imatinib with chemotherapy. This comes from a late-stage trial.

Why it is not certain yet

Median follow-up was 23.7 months, so longer-term results are not in the abstract. So far, only some people in the new plan had a stem cell transplant. Some people in the standard group switched to the new plan.

Source

Ponatinib-Blinatumomab or Imatinib-Chemotherapy for Adult Ph-Positive ALL.

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