Single-center phase 2 trial of dasatinib plus CAR T-cell therapy for newly diagnosed Ph-positive acute lymphoblastic leukemia

A combination of tyrosine kinase inhibitors (TKIs) and CAR T cells has demonstrated activity for relapsed or refractory Ph-positive ALL. A phase 2 trial at Zhejiang University School of Medicine (China) now evaluated the combination of dasatinib and CAR T cells for newly diagnosed Ph-positive ALL in adult patients ((CONSORT diagnram). Patients received two weeks of dasatinib-vindesine-dexamethasone induction, followed by sequential CD19 and CD22 CAR T-cell therapies with dasatinib maintenance. The complete molecular remission rate after CD19 CAR T-cell therapy was 85%. The two-year overall survival and leukemia-free survival rates were 92%. Cytokine release syndrome was only grade 1, and there were no neurotoxic effects. The authors conclude that the combination of dasatinib and CAR T-cell therapy was associated with encouraging efficacy and acceptable toxicity as frontline therapy in adults with Ph-positive ALL.