When will chemotherapy be replaced in upfront induction therapy for adult acute lymphoblastic leukemia (ALL)?

The treatment of acute lymphoblastic leukemia (ALL) has changed significantly over the last decade. With the approval of novel antibody based therapies in the relapsed/refractory setting, many of these agents are starting to be used in the upfront setting in clinical trials for older patients. These results have been impressive, and further trials are underway. Other targeted therapies (i.e. BCL inhibitors) are being explored. This article will discuss the incorporation of novel agents to "replace" chemotherapy in induction.