In a new multicenter international study led by the Mayo Clinic Comprehensive Cancer Center, researchers found that people with the B-cell precursor subtype of acute lymphoblastic leukemia (BCP-ALL), who also lacked a genetic abnormality known as the Philadelphia chromosome and were in remission with no trace of cancer, showed significantly higher survival rates when blinatumomab was added to their chemotherapy treatment. The randomized study results are published this month in the New England Journal of Medicine.
"These results are encouraging and establish a new standard of treatment for people with BCP-ALL," says Mark Litzow, M.D., lead study author and hematologist at the Mayo Clinic Comprehensive Cancer Center. "The addition of blinatumomab to chemotherapy reduced the risk of leukemia recurrence and death by nearly 60%."
Blinatumomab is a type of immunotherapy administered intravenously and brings a normal immune cell called a T cell close to a leukemia cell so it can destroy it. The Food and Drug Administration approved blinatumomab for patients in remission who have traces of cancer, also known as measurable residual disease (MRD)-positive. In this study, blinatumomab was added to see if it could lessen the risk of the ALL coming back and relapsing in a person who had no detection of cancer, also known as MRD-negative, following initial chemotherapy.
The study enrolled 488 participants aged 30 to 70 years with BCP-ALL, and 224 of them were in remission and MRD-negative following the initial course of treatment with chemotherapy. The 224 participants were equally randomized into two arms; the first arm would receive blinatumomab with chemotherapy, and the second arm would receive the standard treatment of chemotherapy alone.
The results showed that 85% of participants treated with blinatumomab and chemotherapy were alive at three years, compared to 68% of those who received chemotherapy alone, which is the standard treatment.
"We plan to build on this study to reduce the amount of chemotherapy people need to receive, ultimately leading to fewer side effects from the treatment and improving overall survival rates," Dr. Litzow says.
This study was conducted by the ECOG-ACRIN Cancer Research Group and funded in part by the National Cancer Institute of the National Institutes of Health. See the full paper for the complete list of funding and authors.
Dr. Litzow has received research funding from Amgen and served on a speaker's bureau for Amgen related to this study.
