Blinatumomab superior to consolidation chemotherapy for some relapsed leukemia patients, study suggests
Researchers from the National Cancer Institute (MD, USA) have presented trial results suggesting that blinatumomab consolidation treatment is superior to standard chemotherapy for pediatric patients with relapsed high- or intermediate-risk B-cell acute lymphoblastic leukemia (B-ALL).
The results of a National Cancer Institute (MD, USA)-led clinical trial suggest that blinatumomab — an immunotherapy drug — is superior to standard chemotherapy as consolidation treatment for pediatric patients with relapsed high- or intermediate-risk B-cell acute lymphoblastic leukemia (B-ALL). Study participants who received blinatumomab presented with fewer severe side effects and had higher rates of undetectable residual disease compared with those in receipt of standard chemotherapy only. The data were presented at the 61st annual meeting of the American Society of Hematology (7—10 December 2019; Orlando, FL, USA).
Individuals with relapsed B-ALL are commonly prescribed two phases of chemotherapy; a ‘reinduction’ phase, which lasts 4—6 weeks, followed by further intensive chemotherapy to reduce disease levels — the ‘consolidation’ treatment phase. Approximately 50% of patients will then be put forward to receive hematopoietic stem cell transplants, depending on the timing of their disease relapse following initial treatment.
However, the serious adverse side effects that chemotherapy can induce may delay, or even entirely prevent, stem cell transplant performance.
In this study, researchers investigated the comparative effectiveness of blinatumomab — an immunotherapy drug that binds to CD19 on cancerous cells and CD3 on T cells, promoting T-cell engagement and attack of cancer cells — versus intensive chemotherapy for consolidation treatment, following reinduction treatment with standard chemotherapy.
For the study, researchers recruited 208 patients, aged 1—30, with relapsed B-ALL. All study participants had already received reinduction chemotherapy and were determined to have high- or intermediate-risk disease. Individuals were randomized to receive either two rounds of intensive chemotherapy or two, 4-week rounds of blinatumomab treatment, before proceeding with stem cell transplants.
Compared with individuals who received chemotherapy consolidation treatment, patients who received blinatumomab displayed greater 2-year, disease-free survival rates, experienced fewer severe adverse side effects and had higher rates of proceeding with stem cell transplants.
Malcolm Smith (National Cancer Institute) stated: “These findings will likely have immediate impact on the treatment of this group of children and young adults with relapsed B-ALL.”
Trial Chair Patrick Brown (Johns Hopkins Kimmel Cancer Center; MD, USA) commented: “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-ALL. We are thrilled that these patients, whose survival has not substantially improved for decades, now have a new and better standard of care.”
Source:
https://cancer.gov/news-events/press-releases/2019/blinatumomab-relapsed-all