A chemo-free regimen improved event-free survival in Ph-positive leukemia

A chemotherapy-free combination improved event-free survival for adults with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia, The ASCO Post reported on November 6, 2026, from a New England Journal of Medicine paper. In the phase III GIMEMA ALL2820 trial, 236 adults were randomly assigned, 158 to ponatinib plus blinatumomab and 78 to imatinib plus chemotherapy. At a median follow-up of 23.7 months, estimated event-free survival at two years was 86 percent with the chemotherapy-free regimen and 67 percent with imatinib plus chemotherapy.

Severe side effects of grade 3 or higher occurred in 34 percent of patients on ponatinib plus blinatumomab and 47 percent on imatinib plus chemotherapy. Overall survival at two years was closer: 90 percent and 85 percent. The corresponding author is Robin Foà of Sapienza University in Rome. The investigators wrote that the trial showed the chemotherapy-free approach was superior as initial treatment, and they noted that follow-up is still relatively short and that the open-label design could introduce bias. Event-free survival counts failure to reach a deep molecular response, toxic effects, resistance, and death. It is not a statement that every patient is cured, and it does not extend past the follow-up the paper reports.