3  Ph positive B-ALL

4 Ponatinib and Blinatumomab

• Short et al. (Jabbour et al. 2023) conducted a phase II trial at MDACC evaluating five cycles of blinatumomab combined with ponatinib in 44 patients.
• The complete molecular remission (CMR) rates were 64% after one course and 85% after treatment completion.
• Using NGS with a sensitivity of 10−6, MRD negativity was confirmed in 88% of cases.

4.1 GIMEMA ALL2820

• the GIMEMA study group designed a phase III trial(ALL2820) comparing blinatumomab and ponatinib to an imatinib-plus-chemotherapy arm

• Preliminary results from the experimental arm were presented at the 66th ASH meeting.(Chiaretti et al. 2024) With a median follow-up of 6.4 months (range 0.1–32.3), the CHR rate was 98%, and the estimated 18-month OS was 91.6%.

Chiaretti, Sabina, Matteo Leoncin, Loredana Elia, et al. 2024. “Efficacy and Toxicity of Frontline Ponatinib Plus Blinatumomab for Adult Ph+ ALL Patients of All Ages. Intermediate Analysis of the Gimema ALL2820.” Blood 144 (Supplement 1): 835–35. https://doi.org/10.1182/blood-2024-207892.

Jabbour, Elias, Nicholas J Short, Nitin Jain, et al. 2023. “Ponatinib and Blinatumomab for Philadelphia Chromosome-Positive Acute Lymphoblastic Leukaemia: A US, Single-Centre, Single-Arm, Phase 2 Trial.” The Lancet Haematology 10 (1): e24–34. https://doi.org/10.1016/s2352-3026(22)00319-2.