Concomitant use of a dual Src/ABL kinase inhibitor eliminates the in vitro efficacy of blinatumomab against Ph+ ALL

Jessica T. Leonard, Yoko Kosaka, Pavani Malla, Dorian LaTocha, Adam Lamble, Brandon Hayes-Lattin, Kaelan Byrd, Brian J. Druker, Jeffrey W. Tyner, Bill H. Chang, Evan Lind

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Blinatumomab is currently approved for use as a single agent in relapsed and refractory acute lymphoblastic leukemia (ALL). Cytotoxicity is mediated via signaling through the T-cell receptor (TCR). There is now much interest in combining blinatumomab with targeted therapies, particularly in Philadelphia chromosome–positive ALL (Ph+ ALL). However, some second- and third-generation ABL inhibitors also potently inhibit Src family kinases that are important in TCR signaling. We combined ABL inhibitors and dual Src/ABL inhibitors with blinatumomab in vitro from both healthy donor samples and primary samples from patients with Ph+ ALL. Blinatumomab alone led to both T-cell proliferation and elimination of target CD19+ cells and enhanced production of interferon-γ (IFN-γ). The addition of the ABL inhibitors imatinib or nilotinib to blinatumomab did not inhibit T-cell proliferation or IFN-γ production. However, the addition of dasatinib or ponatinib inhibited T-cell proliferation and IFN-γ production. Importantly, there was no loss of CD19+ cells treated with blinatumomab plus dasatinib or ponatinib in healthy samples or samples with a resistant ABL T315I mutation by dasatinib in combination with blinatumomab. These in vitro findings bring pause to the excitement of combination therapies, highlighting the importance of maintaining T-cell function with targeted therapies. Key Points: • Dual Src/ABL inhibitors dasatinib and ponatinib inhibited blinatumomab-induced T-cell proliferation in vitro at nanomolar concentrations. • Potential immunomodulatory effects of targeted therapies should be taken into consideration before they are combined with immunotherapies.

Original languageEnglish (US)
Pages (from-to)939-944
Number of pages6
Issue number7
StatePublished - Feb 18 2021

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology


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