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Blinatumomab in adult patients with MRD negative B-ALL: Interim results from the ECOG-ACRIN E1910 trial

By Haimanti Mandal

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Sep 9, 2024

Learning objective: After reading this article, learners will be able to cite a new clinical development in ALL.


Results from the third interim efficacy analysis of the phase III ECOG-ACRIN E1910 trial (NCT02003222) evaluating blinatumomab in combination with standard consolidation chemotherapy in adult patients with BCR::ABL1 negative B-cell precursor acute lymphoblastic leukemia (B-ALL) in measurable residual disease (MRD) negative remission were published in The New England Journal of Medicine by Litzow et al.1 

Key learnings

A total of 224 patients with BCR::ABL1-negative B-ALL in MRD negative remission were included in the analysis. 

  • 112 patients received blinatumomab + chemotherapy and 112 received only chemotherapy. 

  • Median age was 51 years and 50% were female. 

At a median follow-up of 43 months, the 3-year overall survival was significantly improved in the blinatumomab group vs chemotherapy alone group (85% vs 68%; hazard ratio for death, 0.41; 95% confidence interval [CI]: 0.23–0.73; p = 0.002). 

The 3-year relapse-free survival improved in the blinatumomab group vs chemotherapy alone group (80% vs 64%; hazard ratio for relapse or death, 0.53; 95% CI: 0.320.87). 

The incidence of treatment-related Grade ≥3 neurologic or psychiatric adverse events was higher in the blinatumomab group vs chemotherapy alone group (23% vs 5%; p < 0.001). 

The results suggest an overall survival benefit of the addition of blinatumomab to consolidation chemotherapy in adult patients with BCR::ABL1-negative B-ALL in MRD-negative remission; a longer international follow-up is needed to further confirm. 

References

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