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10 March 2017

Researchers have found beneficial results for a new monoclonal antibody drug superior for the treatment of advanced acute lymphoblastic leukaemia.

The experts, from the University of Texas MD Anderson Cancer Center, USA, compared the novel monoclonal antibody blinatumomab against chemotherapy in a phase III randomised trial based at 101 centres in 21 countries.

The drug works by binding to specific cytotoxic T-cells and B-cells, allowing healthy T-cells to recognise and destroy cancer stem cells called blasts.

A total of 405 adult patients were randomly assigned to receive either blinatumomab or chemotherapy. Results showed that overall survival was significantly longer in the blinatumomab group - median survival was 7.7 months versus four months for those on chemotherapy.

Furthermore, remission rates within 12 weeks of starting treatment were higher in the blinatumomab group than the chemotherapy group - with complete remission at 34% on blinatumomab versus 16% on chemotherapy. Those on blinatumomab also had a lower rate of side-effects.

Findings were published on 1 March in The New England Journal of Medicine.

This new treatment approach could help patients stay in remission long enough to receive allogeneic or donor stem cell transplant, say the researchers.

Lead researcher, Dr Hagop Kantarjian, says: 'Among adults with relapsed acute lymphoblastic leukaemia, remission rates are 18% to 44% with standard chemotherapy but the duration of remission is typically short.

'In this study, 24% of patients in each treatment group underwent allogeneic stem cell transplantation.

'The activity of an immune-based therapy such as blinatumomab, which depends on functioning T-cells for its activity, provides encouragement that responses may be further enhanced and made durable with additional immune activation strategies,' he concluded.

Source: Kantarjian, H. et al. Blinatumomab versus Chemotherapy for Advanced Acute Lymphoblastic Leukemia. The New England Journal of Medicine 1 March 2017; doi: 10.1056/NEJMoa1609783


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