A global clinical trial has revealed that incorporating blinatumomab, a targeted immunotherapy drug, into the standard chemotherapy regimen significantly improves disease-free survival (DFS) rates for children with standard-risk (SR) acute lymphoblastic leukemia (ALL). The study, presented at the American Society of Hematology (ASH) Annual Meeting, showed a notable increase in the three-year DFS rate, marking a significant advancement in pediatric oncology.
The trial, which involved over 4,200 children, demonstrated a 96% three-year DFS rate for those receiving blinatumomab in addition to chemotherapy, compared to 87.9% for those treated with chemotherapy alone. These results are so compelling that the Children's Oncology Group (COG) has decided to integrate blinatumomab into its standard protocols for SR ALL, halting ongoing trials to implement this new treatment approach.
How Blinatumomab Works
Blinatumomab, a bispecific T-cell engager, functions by targeting the CD19 protein found on leukemia cells. This mechanism enables the body's immune system to recognize and eliminate cancerous cells more effectively. Unlike traditional chemotherapy, blinatumomab has not shown evidence of causing long-term side effects, making it a crucial advancement for young patients.
Impact on Treatment Protocols
The integration of blinatumomab into the treatment of B-cell ALL marks a significant shift, potentially saving lives and reducing the health impacts associated with relapse. According to Dr. Sumit Gupta, study co-lead, this new combination treatment is set to become the new standard of care, and researchers are exploring whether the amount of chemotherapy can be safely reduced while maintaining high success rates.
Reducing Relapse and Side Effects
For children with an average risk of relapse, the study showed that after three years, the disease-free survival rate increased to 97.5%, compared to 90% with chemotherapy alone. For children with a higher risk of relapse, receiving blinatumomab in addition to chemotherapy increased the disease-free survival rate from 85% to over 94%.
Future Directions
Researchers are also working on a form of blinatumomab that can be administered via subcutaneous injection, eliminating the need for continuous intravenous infusions and further enhancing the quality of life for patients and families. Further clinical trials are planned to continue building on these findings and to ensure safer and more effective care for children with cancer.
According to Dr. Lia Gore, Section Head of the Center for Cancer and Blood Disorders at Children's Hospital Colorado, 96% of patients in the AALL1731 study who received blinatumomab were disease-free for at least three years, and they were 61% less likely to have the cancer relapse than those in the trial who did not receive the drug.
