Results from a big clinical trial show that adding blinatumomab (Blincyto) to the treatment of people with akútna lymfoblastická leukémia (ALL) who are in remission, even if there are no signs of their disease, can help them live longer.
In the study, giving blinatumomab along with chemotherapy made people with cancer that had gone into remission live much longer than those who only got chemotherapy, which is the current standard treatment. Patients in the trial were not only in remission, but there was no sign of their cancer. This is called having minimum residual disease (MRD)-negative ALL.
Výsledky štúdie sa ukázali na výročnom stretnutí Americkej hematologickej spoločnosti (ASH) v New Orleans v decembri 2022.
In 2018, the Food and Drug Administration (FDA) cleared blinatumomab to treat people with MRD-positive ALL who were in remission but still showed signs of cancer during follow-up tests. Even though recurrences after remission are always possible, people with MRD-positive ALL have a higher chance of their cancer coming back after their first treatment than those who do not have MRD.
At the ASH meeting, the results were shown for people who did not have MMR after their first medication.
Po 3.5 roku od začiatku postremisnej terapie bolo ešte nažive 83 % pacientov liečených blinatumomabom a chemoterapiou, zatiaľ čo iba 65 % pacientov liečených samotnou chemoterapiou bolo stále nažive.
Blinatumomab účinný aj pre MRD-negatívnu ALL
B-cell ALL is the most common type of ALL in both adults and children. It is a type of rakovina krvi that spreads quickly and is very dangerous. Chemotherapy is the standard treatment, and it often leads to remission. However, a lot of people get sick again, even if tests done after treatment show no signs of disease.
Immunotherapy drugs have shown some promise as a way to treat cancer after it has gone into remission and lower the risk of it coming back.
Typ imunoterapia called a bispecific T-cell engager (BiTE) is what blinatumomab is. It sticks to both T cells and cancer cells at the same time. This makes it easy for T cells to find and kill the cancer cell by bringing them closer together. The drug, which is given through an IV, has been shown to be more effective than chemotherapy at treating B-ALL that has come back in children and young adults who have already been treated for it.
Táto štúdia, ktorú vedie ECOG-ACRIN Cancer Research Group s pomocou NCI, sa začala v roku 2013 s cieľom zistiť, či blinatumomab môže pomôcť ľuďom, ktorým bola práve diagnostikovaná B-bunková ALL.
Aj keď sa štúdie ako celku zúčastnilo 488 ľudí, výsledky uvedené na ASH sa týkali iba 224 ľudí, ktorí boli v remisii a MRD-negatívni po zvyčajných počiatočných režimoch chemoterapie. Pacientom bola podaná buď ďalšia chemoterapia okrem blinatumomabu, alebo len chemoterapia. Potom všetci jedinci dostávali chemoterapiu každých šesť mesiacov počas 2.5 roka. Niektorí ľudia tiež dostali transplantáciu kostnej drene, ak ich lekár považoval za najlepšie.
Pridanie blinatumomabu k chemoterapii nielenže zlepšilo celkové prežívanie, ale tiež umožnilo pacientom žiť dlhšie bez toho, aby sa ich rakovina vrátila v porovnaní s tými, ktorí dostali iba chemoterapiu.
Dr. Litzow said that none of the people who took blinatumomab had any unexpected side effects. Some of the most common side effects of blinatumomab are fever, responses to the infusion, headaches, infections, tremors, and chills.
