# BCR::ABL1 TKI + blinatumomab (chemotherapy-free Ph+ ALL)

Source: https://onco.cc/pairings/tki-plus-blinatumomab-ph-all/  
OnCo record `tki-plus-blinatumomab-ph-all` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A pill that switches off the leukaemia's engine plus an immunotherapy that mops up survivors, with no chemotherapy.

## Summary

A BCR::ABL1 tyrosine kinase inhibitor, ponatinib or dasatinib, combined with the CD19 bispecific blinatumomab offers chemotherapy-free treatment for adults with Philadelphia chromosome-positive acute lymphoblastic leukaemia. The TKI collapses the Ph-positive clone quickly, and blinatumomab then clears residual disease at the MRD level, including subclones with kinase mutations, because its CD19 mechanism is independent of the kinase. The D-ALBA (GIMEMA LAL2116) trial with dasatinib and the MD Anderson series with ponatinib achieved molecular remission in most adults with far less toxicity than hyper-CVAD. The evidence is phase 2, and randomised comparisons against chemotherapy-containing regimens such as GIMEMA ALL2820 are under way; PhALLCON is the other linked trial.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Ponatinib + Blinatumomab
- Type: combination
- Rationale: TKI collapses the Ph+ clone quickly; blinatumomab clears MRD-level disease that harbours TKI-resistant subclones, and its CD19 mechanism is independent of kinase mutations.
- Evidence: Phase 2 (D-ALBA, MDACC); phase 3 pending.

## Sources

- ClinicalTrials.gov NCT02744768: D-ALBA (GIMEMA LAL2116): https://clinicaltrials.gov/study/NCT02744768
- ClinicalTrials.gov NCT03589326: PhALLCON: https://clinicaltrials.gov/study/NCT03589326

## Connected records

- cancers: [Acute lymphoblastic leukaemia](https://onco.cc/cancers/all-leukemia/), [Chronic myeloid leukaemia, accelerated and blast phase](https://onco.cc/cancers/cml-advanced-phase/), [Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL)](https://onco.cc/cancers/all-paediatric-ph-positive/)
- drugs: [Blinatumomab](https://onco.cc/drugs/blinatumomab/), [Dasatinib](https://onco.cc/drugs/dasatinib/), [Ponatinib](https://onco.cc/drugs/ponatinib/)
- terms: [Ph-positive ALL](https://onco.cc/terms/ph-positive-all/)
- trials: [D-ALBA (GIMEMA LAL2116)](https://onco.cc/trials/d-alba/), [PhALLCON](https://onco.cc/trials/phallcon/)

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