Blinatumomab for Acute Leukemia

AE
LC
Overseen ByLindsay Carter
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Breakthrough TherapyThis drug has been fast-tracked for approval by the FDA given its high promise

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new treatment called blinatumomab, a type of immunotherapy, for CD19-positive MPAL, a form of acute leukemia. The goal is to evaluate the drug's effectiveness in various groups: newly diagnosed patients unable to tolerate strong chemotherapy, those in remission but still showing disease signs, and patients whose leukemia has returned or is unresponsive to treatment. Suitable candidates include individuals with CD19-positive MPAL who meet specific health criteria, such as being 75 or older or having other health issues that make intense chemotherapy unsafe. Participants will receive the treatment through a subcutaneous injection and will attend both hospital and clinic visits for health monitoring. As a Phase 2 trial, this research focuses on assessing the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to significant advancements in leukemia care.

Do I need to stop my current medications to join the trial?

The trial does not specify if you need to stop all current medications, but you cannot be on other investigational agents, chemotherapy, radiation, or immunotherapy for cancer treatment, except for corticosteroids or hydroxyurea. If you have had previous chemotherapy, it must be completed by 5 half-lives of the drug(s) before starting the trial.

Is there any evidence suggesting that blinatumomab is likely to be safe for humans?

Studies have shown that blinatumomab is generally well-tolerated in people with B cell acute lymphoblastic leukemia, a type of blood cancer. Many patients have received blinatumomab, and it has proven effective both as an initial treatment and when the disease recurs after treatment.

Research indicates that some patients experience side effects, such as fever, headache, and low blood cell counts. However, medical help often manages these side effects. Blinatumomab has already received FDA approval for certain uses, indicating that its safety has been thoroughly reviewed in other settings.

For those considering a trial with blinatumomab, studies suggest the possibility of side effects, but the treatment has been used safely in many people before. Always discuss any concerns with a healthcare provider.12345

Why do researchers think this study treatment might be promising?

Unlike the standard chemotherapy treatments for acute leukemia, blinatumomab is a bispecific T-cell engager (BiTE) that uniquely targets the CD19 protein on leukemia cells. This mechanism allows it to harness the body's own immune system to attack cancer cells more directly and effectively. Researchers are particularly excited about the potential for blinatumomab to offer a less intensive treatment option, especially for older patients or those unfit for traditional chemotherapy, as it can be administered subcutaneously, potentially improving the quality of life during treatment. Additionally, blinatumomab's ability to target minimal residual disease (MRD) is promising for achieving deeper remissions in patients.

What evidence suggests that blinatumomab could be an effective treatment for CD19+ MPAL?

Research has shown that blinatumomab can help treat certain types of leukemia that have returned or are difficult to treat. In this trial, participants will join different cohorts to evaluate blinatumomab's efficacy in various contexts. Studies indicate that about 44% of patients respond well to blinatumomab, with an average survival time of 7.7 months. This treatment helps the body's immune system find and destroy cancer cells. For patients with ongoing cancer signs, blinatumomab has shown promise in lowering cancer levels. These findings suggest that blinatumomab can be a valuable option for those with challenging leukemia cases.12356

Who Is on the Research Team?

AE

Ashkan Emadi, MD

Principal Investigator

WVU Cancer Institute

Are You a Good Fit for This Trial?

Adults with CD19-positive Mixed Phenotype Acute Leukemia (MPAL) who are either newly diagnosed and unfit for intensive chemo due to age/conditions, or have had some treatment but still show signs of leukemia, or whose disease has returned or resisted treatment. Participants must be able to perform basic daily activities with minimal assistance.

Inclusion Criteria

Agree to comply with study requirements and attend required visits
My leukemia is confirmed as mixed-phenotype acute leukemia.
I had a stem cell transplant over 4 weeks ago, have mild or no GVHD, and haven't taken immunosuppressants for over a week.
See 4 more

Exclusion Criteria

I am not on any other cancer treatments except for corticosteroids or hydroxyurea.
I do not have an active, uncontrolled infection.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

3 weeks

Treatment

Participants receive subcutaneous blinatumomab in cycles, with each cycle lasting 34 days, including a 26-day treatment period and an 8-day treatment-free interval.

13 months
Inpatient for days 1-12 of cycle 1, outpatient for subsequent doses

Safety Follow-up

A safety follow-up visit occurs 30 days after the last dose of study treatment to monitor for adverse events and overall health.

1 month

Follow-up

Participants are monitored for long-term outcomes, including overall survival and event-free survival.

Up to 3 years

What Are the Treatments Tested in This Trial?

Interventions

  • Blinatumomab
Trial Overview The trial is testing Blinatumomab given under the skin in three groups: untreated elderly patients or those unable to tolerate strong chemo, patients showing minimal residual disease after treatment, and those with relapsed/refractory MPAL. The goal is to see how well it works in these different situations.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Group I: Blinatumomab use in Morphologic R/R CD19+ MPALExperimental Treatment1 Intervention
Group II: Blinatumomab use in CD19+ MPAL in first or second CR/CRh/CRi with detectable MRD ≥0.1%Experimental Treatment1 Intervention
Group III: Blinatumomab in Newly Diagnosed CD19+ MPAL, Age ≥ 75 or Unfit for Intensive ChemotherapyExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

West Virginia University

Lead Sponsor

Trials
192
Recruited
64,700+

Amgen

Industry Sponsor

Trials
1,508
Recruited
1,433,000+
Founded
1980
Headquarters
Thousand Oaks, USA
Known For
Human Therapeutics
Top Products
Enbrel, Prolia, Neulasta, Otezla
Robert A. Bradway profile image

Robert A. Bradway

Amgen

Chief Executive Officer since 2012

MBA from Harvard Business School

Paul Burton profile image

Paul Burton

Amgen

Chief Medical Officer since 2023

MD from University of London, PhD in Molecular and Cellular Biology from Imperial College London

Citations

Effective treatment of relapsed/refractory CD19‐positive B ...A clinical trial of blinatumomab treatment for MPAL is ongoing and results regarding the efficacy are awaited (https://clinicaltrials.gov/study/NCT04827745).
Efficacy and safety of blinatumomab for CD19 + acute ...Results. Thirty-four patients were included, and 88 % completed at least one cycle of blinatumomab. One patient stopped prematurely due to toxicity and three ...
Subcutaneous Blinatumomab for Treatment of Adult ...Cohort A: Evaluate the efficacy of SC-blinatumomab in treating newly diagnosed CD19+ MPAL in patients ≥ 75 years old or those deemed unfit for ...
Blinatumomab in Combination with Immune Checkpoint ...However, the overall response rate to blina was 44%, and median overall survival (OS) is just 7.7 mos (Kantarjian. NEJM.
Full article: Efficacy and safety of blinatumomab for the ...In our analysis, the 1-year OS, 2-year OS, median OS rates, and CR from blinatumomab for post-transplant relapse were 40%, 21%, 7.47 months and ...
Chemotherapy-free treatment of B-lymphoid/myeloid mixed ...This case report presents two cases of B-lymphoid/myeloid MPAL with MLL-AF4 genetic abnormality successfully treated with a chemo-free regimen.
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