Results from a big clinical trial show that adding blinatumomab (Blincyto) to the treatment of people with akutna limfoblastna levkemija (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.
Rezultati preskušanja so bili prikazani na letnem srečanju Ameriškega združenja za hematologijo (ASH) v New Orleansu decembra 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 MRD after their first medication.
3.5 leta po začetku zdravljenja po remisiji je bilo 83 % bolnikov, zdravljenih z blinatumomabom in kemoterapijo, še živih, medtem ko je bilo živih samo 65 % bolnikov, zdravljenih samo s kemoterapijo.
Blinatumomab je učinkovit tudi pri MRD-negativni ALL
B-cell ALL is the most common type of ALL in both adults and children. It is a type of krvni rak 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.
Zdravila za imunoterapijo so pokazala nekaj obetavnega načina za zdravljenje raka, potem ko je šel v remisijo, in zmanjšala tveganje, da se ponovi.
Vrsta imunoterapija 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.
To preskušanje, ki ga izvaja skupina za raziskave raka ECOG-ACRIN s pomočjo NCI, se je začelo leta 2013, da bi ugotovili, ali lahko blinatumomab pomaga ljudem, ki jim je bila pravkar diagnosticirana B-celična ALL.
Čeprav je v celotnem preskušanju sodelovalo 488 ljudi, so bili rezultati, prikazani pri ASH, samo za 224 ljudi, ki so bili po običajnih začetnih režimih kemoterapije v remisiji in negativni na MRD. Bolniki so poleg blinatumomaba prejeli še več kemoterapije ali samo kemoterapijo. Nato so vsi subjekti prejemali kemoterapijo vsakih šest mesecev 2.5 leta. Nekateri ljudje so dobili tudi presaditev kostnega mozga, če je njihov zdravnik menil, da je to najbolje.
Ne samo, da je dodajanje blinatumomaba kemoterapiji izboljšalo splošno preživetje, ampak je tudi podaljšalo življenje bolnikov brez ponovitve raka v primerjavi s tistimi, ki so prejemali samo kemoterapijo.
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.
