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Posted by on Dec 30, 2017 in Leukemia | 0 comments

In a nutshell

This study aimed to investigate the combination of blinatumomab (Blincyto) and a tyrosine kinase inhibitor in patients with relapsed Philadelphia chromosome positive acute lymphoblastic leukemia.

This study concluded that this combination was safe and effective for this group of patients. 

Some background

Philadelphia chromosome positive (Ph positive) acute lymphoblastic leukemia (ALL) is a type of ALL found in 25% of adult ALL cases. This type of ALL is associated with poor prognosis. Standard treatment for relapsed Ph positive ALL involves a combination of a tyrosine kinase inhibitor (TKI) and chemotherapy. TKIs are targeted therapies and work by blocking signals that cancer cells need to grow and reproduce. Chemotherapy involves drugs that kill the cancer cells.

Blinatumomab is a monoclonal antibody used to treat relapsed (cancer returns after treatment) Ph positive ALL. Monoclonal antibodies work by finding and killing cancer cells. It was not known if the combination of blinatumomab and a TKI would be safe and effective in Ph positive ALL patients. 

Methods & findings

This study involved 12 patients who had relapsed Ph positive ALL and CML (chronic myeloid leukemia). They had previously failed to respond to chemotherapy, stem cell transplants, and TKIs. In this study the patients were treated with blinatumomab and one of three TKIs (pontanib, dasatinib or bosutinib). Patients were followed for an average of 8 months after treatment.

The complete hematologic (blood based) response (no sign of active disease) rate to treatment was 50% in these patients. The complete cytogenic (chromosome based) response (decrease in abnormal chromosomes) rate was 71%.  The complete molecular (molecule based) response (no sign of abnormal chromosomes) rate was 75%.

Two patients experienced a side effect known as grade 2 cytokine release syndrome. This was resolved with treatment.

The 6-month overall survival rate (patients who survived for 6 months after treatment) was 73%. The 12-month overall survival rate was also 73%.

The bottom line

This study concluded that the combination of blinatumomab and a TKI is safe and effective for patients with relapsed Ph positive ALL and CML. This combination may reduce the use of chemotherapy.

The fine print

This was a very small group of patients. Further, larger studies are needed. 

What’s next?

Consult your physician about the best treatment option for you. 

Published By :

Clinical lymphoma, myeloma & leukemia

Date :

Dec 01, 2017

Original Title :

Safety and Efficacy of Blinatumomab in Combination With a Tyrosine Kinase Inhibitor for the Treatment of Relapsed Philadelphia Chromosome-positive Leukemia.

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