Sequencing antigen-targeting antibodies and cellular therapies in adults with relapsed/refractory B-cell acute lymphoblastic leukemia

The recent approvals of four CD19-or CD22-targeted therapies for B-cell acute lymphoblastic leukemia (B-ALL) have transformed the treatment of relapsed/refractory (r/r) disease. Adults with r/r B-ALL are usually eligible for all options, but there are no studies directly comparing these agents, and the treating physician must decide which to select. Each therapy has notable activity as a single agent but has limitations in particular settings, and the optimal choice varies. These therapies can be complementary and used either sequentially or concomitantly. Here, we review the current landscape of antigen-targeted therapies for r/r B-ALL and discuss considerations for their use.

Automated summary

The recent approval of four CD19- or CD22-targeted therapies has revolutionized the treatment of relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL). While all options are available for adults with relapsed/refractory B-ALL, there is currently no direct comparison between these agents, leaving the treating physician to make the choice. Each therapy has its own effectiveness as a single agent, though limitations exist for specific situations, and the optimal choice varies. These therapies can be used in combination or sequentially, providing complementary treatment options.