{"entity":{"id":"tki-plus-blinatumomab-ph-all","kind":"pairing","name":"BCR::ABL1 TKI + blinatumomab (chemotherapy-free Ph+ ALL)","aka":[],"tldr":"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.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT02744768: D-ALBA (GIMEMA LAL2116)","url":"https://clinicaltrials.gov/study/NCT02744768"},{"label":"ClinicalTrials.gov NCT03589326: PhALLCON","url":"https://clinicaltrials.gov/study/NCT03589326"}],"tags":[],"related":[],"cancers":["all-leukemia","all-paediatric-ph-positive"],"sections":[],"technologies":[],"targets":[],"drugs":["ponatinib","dasatinib","blinatumomab"],"companies":[],"institutions":[],"pathways":[],"terms":["ph-positive-all"],"trials":["d-alba","phallcon"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"ponatinib","b":"blinatumomab","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.","pairingType":"combination"},"route":"/pairings/tki-plus-blinatumomab-ph-all/","neighbours":{"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"cml-advanced-phase","kind":"cancer","name":"Chronic myeloid leukaemia, accelerated and blast phase","route":"/cancers/cml-advanced-phase/"},{"id":"all-paediatric-ph-positive","kind":"cancer","name":"Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL)","route":"/cancers/all-paediatric-ph-positive/"}],"drug":[{"id":"blinatumomab","kind":"drug","name":"Blinatumomab","route":"/drugs/blinatumomab/"},{"id":"dasatinib","kind":"drug","name":"Dasatinib","route":"/drugs/dasatinib/"},{"id":"ponatinib","kind":"drug","name":"Ponatinib","route":"/drugs/ponatinib/"}],"term":[{"id":"ph-positive-all","kind":"term","name":"Ph-positive ALL","route":"/terms/ph-positive-all/"}],"trial":[{"id":"d-alba","kind":"trial","name":"D-ALBA (GIMEMA LAL2116)","route":"/trials/d-alba/"},{"id":"phallcon","kind":"trial","name":"PhALLCON","route":"/trials/phallcon/"}]}}