Long-term survival of patients with relapsed/refractory acute lymphoblastic leukemia treated with blinatumomab
Por:
Topp, MS, Gokbuget, N, Zugmaier, G, Stein, AS, Dombret, H, Chen, YQ, Ribera, JM, Bargou, RC, Horst, HA and Kantarjian, HM
Publicada:
15 feb 2021
Ahead of Print:
1 nov 2020
Resumen:
Background Blinatumomab is a CD19 BiTE (bispecific T-cell engager) immuno-oncology therapy that mediates the lysis of cells expressing CD19.
Methods A pooled analysis of long-term follow-up data from 2 phase 2 studies that evaluated blinatumomab in heavily pretreated adults with Philadelphia chromosome-negative, relapsed/refractory B-cell precursor acute lymphoblastic leukemia was conducted.
Results A total of 259 patients were included in the analysis. The median overall survival (OS) among all patients, regardless of response, was 7.5 months (95% confidence interval [CI], 5.5-8.5 months); the median follow-up time for OS was 36.0 months (range, 0.3-60.8 months). The median relapse-free survival (RFS) among patients who achieved a complete remission (CR) or complete remission with partial hematologic recovery (CRh) in the first 2 cycles (n = 123) was 7.7 months (95% CI, 6.2-10.0 months); the median follow-up time for RFS was 35.0 months (range, 9.5-59.5 months). OS and RFS plateaued with 3-year rates of 17.7% and 23.4%, respectively. The cumulative incidence function of the time to relapse, with death not due to relapse considered a competing risk, for patients who achieved a CR/CRh within 2 cycles of treatment also plateaued with a 3-year relapse rate of 59.3%. For patients who achieved a CR/CRh with blinatumomab followed by allogeneic hematopoietic stem cell transplantation while in continuous CR, the median OS was 18.1 months (95% CI, 10.3-30.0 months) with a 3-year survival rate of 37.2%.
Conclusions These data suggest that long-term survival is possible after blinatumomab therapy.
Lay Summary
Immuno-oncology therapies such as blinatumomab activate the patient's own immune system to kill cancer cells.
This study combined follow-up data from 2 blinatumomab-related clinical trials to evaluate long-term survival in patients with relapsed and/or refractory B-cell precursor acute lymphoblastic leukemia at high risk for unfavorable outcomes.
Among patients who achieved a deep response with blinatumomab, one-third lived 3 years or longer. These findings suggest that long-term survival is possible after treatment with blinatumomab.
Filiaciones:
Topp, MS:
Univ Klinikum Wurzburg, Wurzburg, Germany
Gokbuget, N:
Goethe Univ, Frankfurt, Germany
Zugmaier, G:
Amgen GmBH, Munich, Germany
Stein, AS:
City Hope Natl Med Ctr, Gehr Family Ctr Leukemia Res, Duarte, CA USA
Dombret, H:
Univ Paris, St Louis Hosp, Paris, France
Chen, YQ:
Amgen Inc, Thousand Oaks, CA 91320 USA
:
Germans Trias & Pujol Hosp, Josep Carreras Leukemia Res Inst, Catalan Inst Oncol, Badalona, Spain
Bargou, RC:
Univ Hosp Wurzburg, Comprehens Canc Ctr Mainfranken, Wurzburg, Germany
Horst, HA:
Univ Hosp Schleswig Holstein, Kiel, Germany
Kantarjian, HM:
Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA
Green Published, hybrid
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