Evaluating blinatumomab for patients with recurrent or non-responsive non-Hodgkin’s lymphoma

This study evaluated the long-term safety and effectiveness of blinatumomab (Blincyto) for non-Hodgkin’s lymphoma (NHL) that has come back or stopped responding to treatment. The authors concluded that blinatumomab showed promising effectiveness for these patients, with minimal side effects.

Chemoimmunotherapy remains the standard first-line treatment for NHL. This type of therapy combines chemotherapy with immunotherapy. While most patients respond to treatment, relapse (cancer recurrence) is common. Many patients also develop tumors that no longer respond to treatment (refractory). These patients need new treatment options.

Blinatumomab was recently approved for the treatment of patients with recurrent or refractory acute lymphoblastic leukemia (ALL). Previous studies suggest that blinatumomab may also be effective for recurrent or refractory NHL. However, the long-term outcomes for these patients after treatment are unclear.

This study had 38 patients with relapsed or refractory NHL. The most common subtype was follicular lymphoma (FL, 47%), followed by mantle cell lymphoma (MCL, 34%). 13% of patients had diffuse large B-cell lymphoma (DLBCL). Patients were divided into three different groups based on treatment dose. 58% of patients received a dose of 60 µg/m² and 34% received less than 60 µg/m². 8% of patients received a dose of 90 µg/m². Patients were followed-up every three months for an average of 4.6 years.

Overall, 64% of patients treated at a dose of 60 µg/m² or higher responded to treatment. 36% of patients had no signs of cancer, and 28% had tumor shrinkage after treatment.

On average, patients survived for an average of 4.6 years after treatment. Patients who responded to treatment survived for significantly longer compared to patients who did not respond to treatment (7.7 years vs. 1.1 years). Blinatumomab treatment was significantly associated with an 80% lower mortality risk.

On average, patients survived for an average of 6.7 months without disease progression (tumor growth or spread). Patients who responded to treatment survived for significantly longer without disease progression compared to patients who did not respond to treatment (3.2 years vs. 31.8 days). Blinatumomab treatment was significantly associated with a 90% lower risk of disease progression.

Patients treated at a dose of 60 µg/m² or higher survived for significantly longer than patients treated with a lower dose (5.8 years vs. 1.1 years). Survival without disease progression was also significantly different between these two groups (1.5 years vs. 32 days). The higher treatment dosage was significantly associated with a 70% lower mortality risk and an 80% lower risk of disease progression.

21% of patients were hospitalized after treatment, mostly due to infections. 2 patients developed pneumonia. 2.5 to 6.25 years after treatment, 3 patients were diagnosed with another type of cancer. 5 patients had their disease transform to DLBCL.

This study concluded that blinatumomab was highly effective for patients with recurrent or refractory NHL, with minimal side effects.

This study was quite small and only took place at one center. Also, the data came from a phase 1 study. More studies are needed to confirm these results and better evaluate long-term outcomes of blinatumomab treatment.