Amgen's Blincyto (blinatumomab) has received FDA approval for the treatment of adult and pediatric patients (one month or older) with CD19-positive Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia (B-ALL) in the consolidation phase, irrespective of measurable residual disease (MRD) status. This approval marks a significant advancement in the treatment of this aggressive blood cancer, offering a new therapeutic option to deepen remission and achieve durable responses.
The FDA's decision was primarily based on the Phase 3 E1910 clinical trial led by the ECOG-ACRIN Cancer Research Group. The study evaluated patients with newly diagnosed Philadelphia chromosome-negative B-ALL undergoing post-induction consolidation treatment. Results indicated that adding Blincyto to multiphase consolidation chemotherapy led to superior overall survival (OS) compared to chemotherapy alone. Specifically, the 3-year OS rate was 84.8% in the Blincyto plus chemotherapy arm (n=112) versus 69% in the chemotherapy arm (n=112), with a hazard ratio for OS of 0.42. At a median follow-up of 4.5 years, the 5-year OS was 82.4% in the Blincyto arm and 62.5% in the chemotherapy arm.
Clinical Impact and Expert Commentary
Dr. Selina M. Luger, professor of hematology-oncology at the University of Pennsylvania's Perelman School of Medicine and Abramson Cancer Center, highlighted the clinical significance of the findings: "In the E1910 study, blinatumomab reduced risk of death and showed a remarkable improvement in overall survival. This approval redefines the standard of care for patients with B-ALL and provides them with a more effective treatment option than standard chemotherapy alone."
E. Anders Kolb, M.D., president and chief executive officer of The Leukemia & Lymphoma Society, emphasized the importance of having another effective option available earlier in a patient's treatment journey, noting that the risk of B-ALL recurrence after the initial phase of treatment remains relatively high.
About the E1910 Study
The E1910 study was independently designed and conducted by ECOG-ACRIN with public funding from the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). Amgen provided Blincyto and support through an NCI Cooperative Research and Development Agreement.
Understanding Acute Lymphoblastic Leukemia (ALL)
Acute Lymphoblastic Leukemia (ALL) is a fast-growing blood cancer that originates in the bone marrow and can spread to other parts of the body, including the lymph nodes, liver, spleen, and central nervous system. B-ALL, the most common type of ALL, begins in immature cells that would normally develop into B-cell lymphocytes. In 2023, approximately 6,540 new cases of ALL were diagnosed in the U.S.
How Blincyto Works
Blincyto is a Bispecific T-cell Engager (BiTE®) immuno-oncology therapy that targets the CD19 surface antigen on B cells. BiTE® molecules work by engaging T cells to cancer cells, activating the cytotoxic potential of T cells to eliminate malignant cells. This mechanism brings T cells near cancer cells, allowing the T cells to inject toxins and trigger cancer cell death (apoptosis).
Safety Information
Blincyto carries a boxed warning for Cytokine Release Syndrome (CRS) and Neurological Toxicities, including Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS). Common adverse reactions include pyrexia, infusion-related reactions, headache, infection, musculoskeletal pain, neutropenia, nausea, anemia, thrombocytopenia, and diarrhea. The drug is administered as a continuous intravenous infusion, and strict adherence to preparation and administration instructions is crucial to minimize medication errors.
