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Giving the bispecific blinatumomab to adults whose leukaemia was already undetectable after chemotherapy raised three-year survival from 68% to 85%.
E1910 enrolled adults aged 30-70 with newly diagnosed Philadelphia-chromosome-negative B-cell ALL. Those who reached MRD-negative remission after induction and intensification (224 patients) were randomised to four cycles of blinatumomab interleaved with consolidation chemotherapy or chemotherapy alone, followed by maintenance. The primary endpoint in this group was overall survival. At three years OS was 85% versus 68% (hazard ratio 0.41) and relapse-free survival 80% versus 64%. Neuropsychiatric events were more frequent with blinatumomab but mostly low grade. The result led to approval of blinatumomab in consolidation for CD19-positive B-ALL regardless of MRD status.
E1910 changed the standard of care for adult B-ALL: immunotherapy is now part of front-line consolidation even for patients with no detectable leukaemia, because MRD-negative by flow cytometry does not mean cured. It also demonstrated that a T-cell engager can improve overall survival in a curative setting. Chemotherapy-light or chemotherapy-free regimens built on blinatumomab and inotuzumab are the next step.
Shares Blinatumomab added to frontline chemotherapy, Children's Oncology Group AALL1731: blinatumomab added to chemotherapy for children with standard-risk B-cell ALL, Blinatumomab, CD3.
Shares Children's Oncology Group AALL1731: blinatumomab added to chemotherapy for children with standard-risk B-cell ALL, Blinatumomab, CD3, CD19.
Shares Blinatumomab, CD3, Amgen, CD19.
Shares Blinatumomab added to frontline chemotherapy, ECOG-ACRIN E1910, Children's Oncology Group AALL1731: blinatumomab added to chemotherapy for children with standard-risk B-cell ALL, Blinatumomab.
Shares Children's Oncology Group AALL1731: blinatumomab added to chemotherapy for children with standard-risk B-cell ALL, Blinatumomab, CD19, Acute lymphoblastic leukaemia.
Shares Blinatumomab, CD3, CD19, T-cell engagers (bispecific).
Shares Blinatumomab, Amgen, T-cell engagers (bispecific), Acute lymphoblastic leukaemia.
Shares CD3, CD19, Bispecific antibodies, T-cell engagers (bispecific).