Leukemia encompasses a group of blood and bone marrow cancers. The Hope Foundation supports research into new therapeutic approaches, including targeted therapies and immunotherapies, to improve remission rates and long-term outcomes for leukemia patients.
SWOG Trial Shows a Chemo-Free Approach Can Deliver Long-Term Survival for Older Patients with a Hard-to-Treat Leukemia
For decades, the standard treatment for acute lymphoblastic leukemia (ALL) has centered on intensive chemotherapy. But for older patients, particularly those aged 65 and up, that approach is often not a viable option. The side effects can be too severe, and many older patients simply cannot tolerate it. A SWOG trial called S1318 established a compelling case that a gentler, chemotherapy-free regimen can still deliver durable, long-term results for this group.
S1318 focused specifically on patients with a form of ALL that carries what’s called the Philadelphia chromosome, a genetic abnormality that affects how leukemia cells grow and can be targeted with a class of drugs called tyrosine kinase inhibitors (TKIs). Many older patients with Philadelphia chromosome-positive ALL are not good candidates for intensive chemotherapy and have historically been treated with TKIs plus corticosteroids, an approach that achieves high remission rates but short disease-free survival.
S1318 tested a combination treatment that added the immunotherapy drug blinatumomab –a bispecific T-cell engager that helps the immune system find and destroy leukemia cells – to dasatinib (a TKI) and prednisone (a corticosteroid), all without intensive chemotherapy.
The latest update — ASH 2025:
At the December 2025 ASH Annual Meeting, S1318 study chair Dr. Anjali Advani presented further follow-up data along with new analyses of predictors of outcomes in this patient population, deepening the understanding of who benefits most from this regimen and why.
Why it matters:
S1318 demonstrates that for older patients with Philadelphia chromosome-positive ALL, a targeted plus immunotherapy combination can achieve remissions that hold up over years. The results have meaningful implications for how this leukemia is treated in real-world practice, particularly in community settings where older and frailer patients are most often seen.