A study found that patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) who received blinatumomab and ponatinib could discontinue maintenance tyrosine kinase inhibitor (TKI) therapy and sustain favorable survival outcomes. Survival was even more favorable for patients in the first- or second-line treatment setting.
Abigail Huetteman, MD, of the University of South Florida, and colleagues presented the findings at the 2026 SOHO Annual Meeting.
Guidelines recommend maintenance TKI monotherapy following remission, though data are limited regarding outcomes following TKI discontinuation. Researchers sought to evaluate long-term outcomes in this scenario.
The retrospective, observational, single-center study included 31 adult patients (median age, 49 years) treated at the Moffitt Cancer Center between January 1, 2017, and October 1, 2025. Half of patients (n=16; 51.6%) had relapsed or refractory disease, about half (n=15; 48.4%) received prior TKIs, and eight patients (25.8%) had an IKZF1 mutation. At diagnosis, the median white blood cell count was 71×103/µL.
Patients received a median of three cycles of blinatumomab and had a median follow-up of 54.2 months, with a median TKI duration of 30.3 months. A majority of patients (64.5%) reached measurable residual disease (MRD) negativity at the final blinatumomab cycle.
Median overall survival (OS) and event-free survival (EFS) were not reached; 48- and 60-month OS rates were 96.0% and 88.9%, respectively. The 24-month EFS rate following TKI discontinuation was:
- 79.5% in the entire cohort
- 77.9% in the MRD-negative cohort
- 66.7% in the MRD-positive cohort
Patients who were in the first- or second-line treatment cohort (n=22) experienced superior EFS and OS after TKI discontinuation: OS was 100% with only one relapse was reported compared with an OS of 75% in patients in the third-line and beyond setting (P=0.017). The 24-month EFS was 90.9% and 55.6%, respectively (P=0.011).
Reference
Huetteman A, Azem A, Walgenbach D, et al. Outcomes after TKI discontinuation in patients with Ph+ ALL treated with blinatumomab and ponatinib. Abstract ALL-1317. Presented at the 2026 Society of Hematologic Oncology Annual Meeting; September 9-12, 2026; Houston.
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