TKI Maintenance After Brexu-Cel in Ph+ ALL
Othman T, Roloff GW, Miller K, et al. Improved Outcomes With TKI Maintenance Following Brexucabtagene Autoleucel in Philadelphia-Chromosome ALL. Blood Advances. 2026; (doi: 10.1182/bloodadvances.2026020707).
Researchers report that following up brexucabtagene autoleucel (brexu-cel) treatment with tyrosine kinase inhibitor (TKI)-based maintenance therapy produces a survival benefit in adults with Philadelphia-chromosome positive (Ph+) acute lymphoblastic leukemia (ALL). The finding applies to patients with relapsed/refractory disease who achieved measurable residual disease (MRD)-negative complete response (CR) following brexu-cel therapy. In a real-world analysis of patients with relapsed/refractory Ph+ ALL who received commercial brexu-cel and achieved MRD-negative CR, investigators compared outcomes in 20 patients who subsequently received TKI maintenance and 31 who did not. The TKI group had a markedly lower 1-year cumulative incidence of relapse, leading to a superior rate of progression-free survival than was observed in the non-TKI cohort. With a trend toward enhanced overall survival and a comparable incidence of non-relapse mortality to that observed in non-TKI recipients, the study authors say their results justify TKI maintenance after brexu-cel in this specific patient population.