Efficacy and safety of bispecific T-cell engager blinatumomab and the potential to improve leukemia-free survival in B-cell acute lymphoblastic leukemia

ABSTRACT

Introduction: Immunotherapy is a promising modality of treatment of neoplastic diseases, including acute lymphoblastic leukemia (ALL). The CD19/CD3-bispecific T cell–engaging (BiTE®) monoclonal antibody blinatumomab can transiently bind cytotoxic T cells to CD19⁺ target B cells of ALL inducing their serial lysis.

Areas covered: This review focuses on the efficacy and safety of blinatumomab used for the treatment of relapsed/refractory (R/R) ALL and minimal residual disease (MRD)-positive B-cell precursor (BCP) ALL in adults and children, as well as the future prospects of this drug in the treatment of ALL.

Expert commentary: Blinatumomab has demonstrated encouraging response rates in MRD-positive and R/R in adults with Philadelphia chromosome-positive and -negative ALL, as well as in children with R/R ALL. Blinatumomab has a favorable safety profile, although reversible CNS events and cytokine release syndrome can occur. Ongoing trials in ALL incorporate blinatumomab in the first line therapy of BCP ALL in combination with chemotherapy, targeted therapies or other immunotherapies with the aim of increasing the depth of the remission and decreasing the probability of relapse.

KEYWORDS:

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

Declaration of interest

The authors have no 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.

One peer reviewer has declared receipt of advisory board fees from Amgen but has no other relevant financial relationships to disclose.

Additional information

Funding

This paper was supported in part by 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; PI14/01971 from Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, and a grant from Obra Social La Caixa.