Blinatumomab for treating acute lymphoblastic leukemia

Abstract

Introduction: Immunotherapy is a promising modality of treatment for neoplastic diseases. The CD19/CD3-bispecific T cell-engaging (BiTE®) monoclonal antibody blinatumomab can transiently engage any cytotoxic T cells to CD19⁺ target B cells inducing their serial lysis. Blinatumomab has shown promising activity in B-cell non-Hodgkin’s lymphomas and, especially, in B-cell precursor acute lymphoblastic leukemia (ALL).

Areas covered: This review focuses on the chemistry, pharmacological properties, clinical activity as well as the safety and tolerability of blinatumomab used in the treatment of relapsed/refractory (R/R) (including minimal residual disease-positive [MRD+]) ALL in adults and children.

Expert opinion: Blinatumomab has demonstrated encouraging response rates in the setting of MRD+ and in R/R ALL in adults and children. Blinatumomab has a favorable safety profile, although reversible CNS events and cytokine release syndrome can occur. Encouraging reports on the activity of blinatumomab in the R/R B-cell precursor ALL led to its approval by the US FDA after an accelerated review process on 3 December 2014.

Keywords:

• acute lymphoblastic leukemia
• BiTE® monoclonal antibodies
• blinatumomab
• minimal residual disease-positive
• relapsed/refractory

Declaration of interest

This work has been supported in part by grants from the Red Temática de Investigación Cooperativa en Cáncer (RTICC, FEDER) (RD12/0036/0029); 2014 SGR225 (GRE) Generalitat de Catalunya; and PI14/01971 from Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, Spain and a grant from Obra Social La Caixa. JMR has participated in some clinical trials of blinatumomab and on advisory boards for AMGEN. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.