{"entity":{"id":"tower","kind":"trial","name":"TOWER","aka":[],"tldr":"The first randomised proof that a T-cell engager beats chemotherapy: blinatumomab nearly doubled survival in relapsed adult ALL.","summary":"TOWER, trial NCT02013167 sponsored by Amgen and published in the New England Journal of Medicine in 2017, was the first randomised proof that a T-cell engager beats chemotherapy: blinatumomab nearly doubled survival in relapsed or refractory Philadelphia-negative B-cell acute lymphoblastic leukaemia in adults. It randomised 405 patients to blinatumomab or standard salvage chemotherapy, met its primary overall survival endpoint, doubled the complete remission rate within twelve weeks, and most blinatumomab responders became MRD-negative, converting the 2014 accelerated approval to full approval. OnCo links it to acute lymphoblastic leukaemia, T-cell engagers, CD19 and CD3 as targets and blinatumomab. Whether blinatumomab can replace chemotherapy blocks altogether is the open question.","status":"positive","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT02013167","url":"https://clinicaltrials.gov/study/NCT02013167"}],"tags":[],"related":[],"cancers":["all-leukemia"],"sections":[],"technologies":["t-cell-engager"],"targets":["cd19","cd3"],"drugs":["blinatumomab"],"companies":["amgen"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT02013167","phase":"3","setting":"Relapsed or refractory Ph-negative B-ALL, adults: blinatumomab vs standard salvage chemotherapy","sponsor":"Amgen","result":"OS 7.7 vs 4.0 months; HR 0.71.","started":"2014-01-03","startedType":"actual","yearReported":2017,"enrolled":405,"enrolledBasis":"registry","outcomes":[{"endpoint":"Overall survival (median)","primary":true,"unit":"months","arms":[{"name":"Blinatumomab","n":271,"value":7.7},{"name":"Chemotherapy","n":134,"value":4}],"hr":0.71,"ci":[0.55,0.93],"p":"0.01","source":"https://www.nejm.org/doi/full/10.1056/NEJMoa1609783"},{"endpoint":"Complete remission within 12 weeks","unit":"%","arms":[{"name":"Blinatumomab","value":34},{"name":"Chemotherapy","value":16}],"source":"https://doi.org/10.1056/NEJMoa1609783"}],"replication":"RIALTO (children) and BLAST (MRD-positive) reproduced high MRD-negative remission rates; E1910 and AALL1731 confirmed benefit frontline."},"route":"/trials/tower/","neighbours":{"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"}],"technology":[{"id":"t-cell-engager","kind":"technology","name":"T-cell engagers (bispecific)","route":"/technologies/t-cell-engager/"}],"target":[{"id":"cd19","kind":"target","name":"CD19","route":"/targets/cd19/"},{"id":"cd3","kind":"target","name":"CD3","route":"/targets/cd3/"}],"drug":[{"id":"blinatumomab","kind":"drug","name":"Blinatumomab","route":"/drugs/blinatumomab/"}],"company":[{"id":"amgen","kind":"company","name":"Amgen","route":"/companies/amgen/"}],"paper":[{"id":"paper-blinatumomab-all-leukemia-n-engl-j-med-2017","kind":"paper","name":"Blinatumomab versus Chemotherapy for Advanced Acute Lymphoblastic Leukemia","route":"/key-papers/paper-blinatumomab-all-leukemia-n-engl-j-med-2017/"}],"roadmap":[{"id":"paediatric-oncology-roadmap","kind":"roadmap","name":"Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first","route":"/roadmaps/paediatric-oncology-roadmap/"}]}}