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The first randomised proof that a T-cell engager beats chemotherapy: blinatumomab nearly doubled survival in relapsed adult ALL.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
405 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival (median)primary | Blinatumomab | 271 | 7.7 months | 0.71 (0.55 to 0.93) | 0.01 | link |
| Chemotherapy | 134 | 4 months | ||||
| Complete remission within 12 weeks | Blinatumomab | - | 34% | - | - | link |
| Chemotherapy | - | 16% |
Shares Blinatumomab, Amgen, T-cell engagers (bispecific), Acute lymphoblastic leukaemia.
Shares Blinatumomab, Amgen, T-cell engagers (bispecific), Acute lymphoblastic leukaemia.
Shares Blinatumomab, CD3, CD19, T-cell engagers (bispecific).
Shares Blinatumomab, CD3, CD19, T-cell engagers (bispecific).
Shares Blinatumomab, CD19, T-cell engagers (bispecific), Acute lymphoblastic leukaemia.
Shares Blinatumomab, CD3, CD19, Acute lymphoblastic leukaemia.
Shares Blinatumomab, CD3, Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, CD19.
Shares CD3, CD19, T-cell engagers (bispecific).