Abstract | BACKGROUND: METHODS: In the TOWER study, adults with R/R ALL were randomized 2:1 to receive blinatumomab or SOC. Study treatment consisted of 2 cycles of induction with blinatumomab or SOC followed by consolidation and maintenance therapy. At any time after the first cycle, patients who were eligible for HSCT could proceed to HSCT. RESULTS: Of the 97 patients who underwent HSCT during the study, baseline characteristics generally were comparable and donor types were similar between the patients treated with blinatumomab (65 patients) and those receiving SOC (32 patients). There was no evidence to suggest that the survival benefit of HSCT differed between the patients treated with blinatumomab and those receiving SOC (P = .68). On the basis of descriptive statistics, a survival benefit of HSCT versus no HSCT was not observed in patients who achieved complete remission with full, partial, or incomplete hematologic recovery with blinatumomab (odds ratio, 1.17; 95% CI, 0.54-2.53). The best outcomes were achieved in patients with no prior salvage therapy and with minimal residual disease response to blinatumomab regardless of on-study HSCT status. CONCLUSIONS: Survival was found to be driven by response to study treatment and by salvage status regardless of on-study HSCT status. These data should be interpreted with caution because the current study was not designed to prospectively assess survival outcomes associated with HSCT after blinatumomab. LAY SUMMARY:
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Authors | Elias J Jabbour, Nicola Gökbuget, Hagop M Kantarjian, Xavier Thomas, Richard A Larson, Sung-Soo Yoon, Armin Ghobadi, Max S Topp, Qui Tran, Janet L Franklin, Stephen J Forman, Anthony S Stein |
Journal | Cancer
(Cancer)
Vol. 125
Issue 23
Pg. 4181-4192
(Dec 01 2019)
ISSN: 1097-0142 [Electronic] United States |
PMID | 31433496
(Publication Type: Journal Article)
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Copyright | © 2019 American Cancer Society. |
Chemical References |
- Antibodies, Bispecific
- Antineoplastic Agents
- blinatumomab
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Topics |
- Adolescent
- Adult
- Aged
- Antibodies, Bispecific
(pharmacology, therapeutic use)
- Antineoplastic Agents
(pharmacology, therapeutic use)
- Female
- Hematopoietic Stem Cell Transplantation
(methods)
- Humans
- Male
- Middle Aged
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
(drug therapy, mortality, therapy)
- Survival Rate
- Transplantation Conditioning
(methods)
- Young Adult
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