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Blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory B‐cell precursor acute lymphoblastic leukemia: Results of a pooled analysis

Background Blinatumomab is a BiTE(®) immuno‐oncology therapy indicated for the treatment of patients with relapsed or refractory (r/r) B‐cell precursor (BCP) acute lymphoblastic leukemia (ALL). AIMS: To assess the efficacy and safety of blinatumomab as first salvage versus second or later salvage in...

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Autores principales: Topp, Max S., Stein, Anthony S., Gökbuget, Nicola, Horst, Heinz‐August, Boissel, Nicolas, Martinelli, Giovanni, Kantarjian, Hagop, Brüggemann, Monika, Chen, Yuqi, Zugmaier, Gerhard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026950/
https://www.ncbi.nlm.nih.gov/pubmed/33734596
http://dx.doi.org/10.1002/cam4.3731
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author Topp, Max S.
Stein, Anthony S.
Gökbuget, Nicola
Horst, Heinz‐August
Boissel, Nicolas
Martinelli, Giovanni
Kantarjian, Hagop
Brüggemann, Monika
Chen, Yuqi
Zugmaier, Gerhard
author_facet Topp, Max S.
Stein, Anthony S.
Gökbuget, Nicola
Horst, Heinz‐August
Boissel, Nicolas
Martinelli, Giovanni
Kantarjian, Hagop
Brüggemann, Monika
Chen, Yuqi
Zugmaier, Gerhard
author_sort Topp, Max S.
collection PubMed
description Background Blinatumomab is a BiTE(®) immuno‐oncology therapy indicated for the treatment of patients with relapsed or refractory (r/r) B‐cell precursor (BCP) acute lymphoblastic leukemia (ALL). AIMS: To assess the efficacy and safety of blinatumomab as first salvage versus second or later salvage in patients with r/r BCP ALL. MATERIALS & METHODS: Patient‐level pooled data were used for this analysis. In total, 532 adults with r/r BCP ALL treated with blinatumomab were included (first salvage, n = 165; second or later salvage, n = 367). RESULTS: Compared with patients who received blinatumomab as second or later salvage, those who received blinatumomab as first salvage had a longer median overall survival (OS; 10.4 vs. 5.7 months; HR, 1.58; 95% CI, 1.26–1.97; P < .001) and relapse‐free survival (10.1 vs. 7.3 months; HR, 1.38; 95% CI, 0.98–1.93; P = .061), and higher rates of remission (n = 89 [54%] vs. n = 150 [41%]; odds ratio, 0.59; 95% CI, 0.41–0.85; P = .005), minimal residual disease response (n = 68 [41%] vs. n = 118 [32%]), and allogeneic hematopoietic stem cell transplant (alloHSCT) realization (n = 60 [36%] vs. n = 88 [24%]), and alloHSCT in continuous remission (n = 33 [20%] vs. n = 52 (14%]). In a subgroup analysis, there was no apparent effect of prior alloHSCT on median OS in either salvage group. The safety profile of blinatumomab was generally similar between the groups; however, cytokine release syndrome, febrile neutropenia, and infection were more frequent with second or later salvage than with first salvage. DISCUSSION: In this pooled analysis, the logistic regression analyses indicated greater benefit with blinatumomab as first salvage than as second or later salvage, as evident by the longer median OS, longer median RFS, and higher rates of remission. CONCLUSION: Overall, blinatumomab was beneficial as first salvage and as second or later salvage, but the effects were favorable as first salvage.
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spelling pubmed-80269502021-04-13 Blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory B‐cell precursor acute lymphoblastic leukemia: Results of a pooled analysis Topp, Max S. Stein, Anthony S. Gökbuget, Nicola Horst, Heinz‐August Boissel, Nicolas Martinelli, Giovanni Kantarjian, Hagop Brüggemann, Monika Chen, Yuqi Zugmaier, Gerhard Cancer Med Clinical Cancer Research Background Blinatumomab is a BiTE(®) immuno‐oncology therapy indicated for the treatment of patients with relapsed or refractory (r/r) B‐cell precursor (BCP) acute lymphoblastic leukemia (ALL). AIMS: To assess the efficacy and safety of blinatumomab as first salvage versus second or later salvage in patients with r/r BCP ALL. MATERIALS & METHODS: Patient‐level pooled data were used for this analysis. In total, 532 adults with r/r BCP ALL treated with blinatumomab were included (first salvage, n = 165; second or later salvage, n = 367). RESULTS: Compared with patients who received blinatumomab as second or later salvage, those who received blinatumomab as first salvage had a longer median overall survival (OS; 10.4 vs. 5.7 months; HR, 1.58; 95% CI, 1.26–1.97; P < .001) and relapse‐free survival (10.1 vs. 7.3 months; HR, 1.38; 95% CI, 0.98–1.93; P = .061), and higher rates of remission (n = 89 [54%] vs. n = 150 [41%]; odds ratio, 0.59; 95% CI, 0.41–0.85; P = .005), minimal residual disease response (n = 68 [41%] vs. n = 118 [32%]), and allogeneic hematopoietic stem cell transplant (alloHSCT) realization (n = 60 [36%] vs. n = 88 [24%]), and alloHSCT in continuous remission (n = 33 [20%] vs. n = 52 (14%]). In a subgroup analysis, there was no apparent effect of prior alloHSCT on median OS in either salvage group. The safety profile of blinatumomab was generally similar between the groups; however, cytokine release syndrome, febrile neutropenia, and infection were more frequent with second or later salvage than with first salvage. DISCUSSION: In this pooled analysis, the logistic regression analyses indicated greater benefit with blinatumomab as first salvage than as second or later salvage, as evident by the longer median OS, longer median RFS, and higher rates of remission. CONCLUSION: Overall, blinatumomab was beneficial as first salvage and as second or later salvage, but the effects were favorable as first salvage. John Wiley and Sons Inc. 2021-03-18 /pmc/articles/PMC8026950/ /pubmed/33734596 http://dx.doi.org/10.1002/cam4.3731 Text en © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Topp, Max S.
Stein, Anthony S.
Gökbuget, Nicola
Horst, Heinz‐August
Boissel, Nicolas
Martinelli, Giovanni
Kantarjian, Hagop
Brüggemann, Monika
Chen, Yuqi
Zugmaier, Gerhard
Blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory B‐cell precursor acute lymphoblastic leukemia: Results of a pooled analysis
title Blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory B‐cell precursor acute lymphoblastic leukemia: Results of a pooled analysis
title_full Blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory B‐cell precursor acute lymphoblastic leukemia: Results of a pooled analysis
title_fullStr Blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory B‐cell precursor acute lymphoblastic leukemia: Results of a pooled analysis
title_full_unstemmed Blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory B‐cell precursor acute lymphoblastic leukemia: Results of a pooled analysis
title_short Blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory B‐cell precursor acute lymphoblastic leukemia: Results of a pooled analysis
title_sort blinatumomab as first salvage versus second or later salvage in adults with relapsed/refractory b‐cell precursor acute lymphoblastic leukemia: results of a pooled analysis
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026950/
https://www.ncbi.nlm.nih.gov/pubmed/33734596
http://dx.doi.org/10.1002/cam4.3731
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