Immunotherapy, Chemotherapy and radiotherapy all consist the treatment protocols against different types of malignancies. Although in many cases of ALL immunotherapy opened a new promising windodw infront of oncologists, due to the heterogenicity of tumors among different indiviuals this in not very clear that which strategy will result in best clinical outcome! In fact this is more related to the origin of disease and the patients condition than potential of treatment strategy. I think that personalized medicine comes in handy to decide which one is the best for each person! Hope it would be of help.
In the present scenario, immunotherapy is used along with chemotherapy upfront in adult ALL by addition of Rituximab to chemotherapy in CD20 + adult ALL. Blinotumomab is used as single agent in relapsed refractory ALL in adults and children.
At this stage, we don't have evidence to say if immunotherapy can be used alone in upfront setting in paediatric patients. Hopefully clinical trials will be able to answer this question in future.
It you are referring to CAR-T cell tx, to date this has been used only in relapsed cases. ALL in the pediatric age group is still a very curable disease with standard chemotherapy.
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