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Two courses of blinatumomab added to standard chemotherapy cut relapses in children with average- or higher-risk standard-risk leukaemia, raising three-year disease-free survival from 88% to 96%.
AALL1731 was a phase 3 Children's Oncology Group trial in children aged 1 to under 10 with newly diagnosed National Cancer Institute standard-risk B-cell ALL. Those with average- or high-risk features after induction (1440 patients) were randomised to standard chemotherapy or the same chemotherapy with two 28-day cycles of blinatumomab. The primary endpoint was disease-free survival. At the first interim analysis three-year DFS was 96.0% with blinatumomab versus 87.9% (hazard ratio 0.39), and randomisation was stopped early for efficacy. Sepsis and catheter-related infections were more frequent with blinatumomab, but there were few grade 3 or higher CRS or neurological events.
AALL1731 brings immunotherapy into the front-line treatment of the commonest childhood cancer, in the group of children where most relapses were occurring despite good initial risk. Blinatumomab was approved for this use in 2024 and paediatric protocols worldwide are being amended. Whether it can allow less chemotherapy, and its effect on very low-risk children, are the next questions.
Shares Blinatumomab added to frontline chemotherapy, ECOG-ACRIN E1910: adding blinatumomab to chemotherapy for adults with B-cell ALL already in MRD-negative remission, Standard-risk B-cell acute lymphoblastic leukaemia in children, Blinatumomab.
Shares Blinatumomab, CD3, Amgen, CD19.
Shares ECOG-ACRIN E1910: adding blinatumomab to chemotherapy for adults with B-cell ALL already in MRD-negative remission, Blinatumomab, CD19, T-cell engagers (bispecific).
Shares ECOG-ACRIN E1910: adding blinatumomab to chemotherapy for adults with B-cell ALL already in MRD-negative remission, Blinatumomab, CD3, CD19.
Shares Blinatumomab, CD3, CD19, T-cell engagers (bispecific).
Shares Blinatumomab, Amgen, T-cell engagers (bispecific), Acute lymphoblastic leukaemia.
Shares Blinatumomab, Amgen, T-cell engagers (bispecific), Acute lymphoblastic leukaemia.
Shares CD3, CD19, Bispecific antibodies, T-cell engagers (bispecific).