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Table 2 Published trials of combination of novel agents in adult Ph-negative ALL

From: Evolving therapy of adult acute lymphoblastic leukemia: state-of-the-art treatment and future directions

Regimen

Patient population

N

Median age [range], years

Induction mortality, %

CR/CRi rate, %

MRD negativity, %

HSCT rate, %

CR duration, %

OS rate, %

Reference

R/R Ph-negative ALL

Mini-HCVD + InO ± blinatumomab

Primary refractory 13%

CR1 duration < 1 year 40%

Prior HSCT 23%

84

35 [9-87]

2

80

80

40

52% (2-year)

39 (2-year)

[28]

CVP + InO (SWOG 1312)

Salvage 1: 44%

Prior blinatumomab 38%

Prior HSCT 19%

48

43 [20-79]

2

61

NR

30

NR

Median 10.9 months

[29]

Venetoclax + navitoclax

B cell ALL 50%

T cell ALL 50%

Median prior therapies: 4

Prior HSCT 14%

Prior CAR T cells 17%

36

29 [6-72]

8

56

56

25

44% (6-month)

NR

[30]

Frontline Ph-negative older ALL

Mini-HCVD + InO ± blinatumomab

Age ≥ 60 years

64

68 [60-81]

0

98

95

5

76% (3-year)

54 (3-year)

[31]

Blinatumomab + POMP (SWOG 1318)

Age > 60 years

31

73 [66-84]

0

66

92

3

DFS 56 (1-year)

65 (1-year)

[32]

Frontline Ph-negative younger ALL

Sequential HCVAD + blinatumomab

Age < 60 years

27

38 [18-59]

0

100

96

30

RFS 76 (1-year)

89 (1-year)

[33]

  1. Ph Philadelphia-chromosome; ALL acute lymphoblastic leukemia; N number, CR1 first complete remission; CR complete remission; CRi complete remission with incomplete hematologic recovery; MRD measurable residual disease; OS overall survival; EFS event-free survival; RFS relapse-free survival; mini-HCVD mini-hyperfractionated cyclophosphamide, vincristine, dexamethasone; InO inotuzumab ozogamicin; HSCT hematopoietic stem cell transplant; CAR chimeric antigen receptor; HCVAD hyperfractionated cyclophosphamide, vincristine, Adriamycin, dexamethasone; CVP cyclophosphamide, vincristine, prednisone; SWOG South west oncology group; POMP prednisone, vincristine, methotrexate, mercaptopurine