16 December 2019

A trial of the immunotherapy drug blinatumomab for relapsed B-cell acute lymphoblastic leukaemia (ALL) has shown that it significantly improves survival, a major conference has heard.

The trial was led by Dr Patrick Brown of the Johns Hopkins Kimmel Cancer Center in Baltimore, USA. His research team compared blinatumomab against standard chemotherapy for consolidation therapy, for children and young adults with relapsed high- or intermediate-risk B-cell ALL.

Results were presented at the American Society of Hematology annual meeting in Orlando, Florida. The researchers say that blinatumomab is superior for this patient group in terms of survival, side effects, and residual disease. The group given the drug also had a higher chance of being suitable for stem cell transplant.

The randomised trial involved some 208 children and young adults aged between 1 and 30 years old,  with a median follow-up of 1.4 years. 59% of those receiving blinatumomab survived for two years, compared with 41% of those receiving standard chemotherapy. The new drug was also associated with reduced side effects and high rates of achieving undetectable residual disease. 73% of blinatumomab recipients proceeded to a potentially curative stem cell transplant, compared to just 45% of patients receiving chemotherapy.

Dr Brown said: “Our study demonstrates that immunotherapy with blinatumomab is more effective and less toxic than chemotherapy as a bridge to curative bone marrow transplant for children and young adults with very aggressive relapse of B-cell acute lymphoblastic leukaemia.

“We are thrilled that these patients, whose survival has not substantially improved for decades, now have a new and better standard of care.”

The National Cancer Institute oversees the Children’s Oncology Group, which ran the trial.

Dr Malcolm Smith of the National Cancer Institute commented: “These findings will likely have immediate impact on the treatment of this group of children and young adults with relapsed B-cell acute lymphoblastic leukaemia.

Blinatumomab is a bispecific antibody which binds to the molecules CD19, an antigen on the surface of leukaemia cells, and CD3 which is an antigen expressed on T cells. This twin action aids T cells in recognising and killing the cancer cells.

 

Source: ASH 10th December 2019

Link: https://ash.confex.com/ash/2019/webprogram/Paper132435.html