Results from a big clinical trial show that adding blinatumomab (Blincyto) to the treatment of people with talamak na lymphoblastic leukemia (LAHAT) 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.
Ang mga resulta ng pagsubok ay ipinakita sa taunang pagpupulong ng American Society of Hematology (ASH) sa New Orleans noong Disyembre 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.
Sa 3.5 taon pagkatapos simulan ang post-remission therapy, 83% ng mga pasyente na ginagamot ng blinatumomab at chemotherapy ay buhay pa, habang 65% lamang ng mga pasyente na ginagamot sa chemotherapy lamang ang nabubuhay pa.
Ang Blinatumomab ay epektibo para sa MRD-negative ALL din
B-cell ALL is the most common type of ALL in both adults and children. It is a type of kanser sa dugo 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.
Ang mga immunotherapy na gamot ay nagpakita ng ilang pangako bilang isang paraan upang gamutin ang kanser pagkatapos nitong mapawi at mapababa ang panganib na bumalik ito.
Isang uri ng immunotherapy 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.
Ang pagsubok na ito, na pinamamahalaan ng ECOG-ACRIN Cancer Research Group sa tulong mula sa NCI, ay nagsimula noong 2013 upang makita kung ang blinatumomab ay makakatulong sa mga taong na-diagnose na may B-cell ALL.
Kahit na 488 na tao ang nakibahagi sa pagsubok sa kabuuan, ang mga resultang ipinakita sa ASH ay para lamang sa 224 na tao na nasa remission at MRD-negative pagkatapos ng karaniwang mga paunang regimen ng chemotherapy. Ang mga pasyente ay binigyan ng alinman sa higit pang chemotherapy bilang karagdagan sa blinatumomab o chemotherapy lamang. Pagkatapos, ang lahat ng mga paksa ay nakakuha ng chemotherapy tuwing anim na buwan sa loob ng 2.5 taon. Ang ilang mga tao ay nagpa-transplant din ng bone marrow kung sa tingin ng kanilang doktor ay ito ang pinakamabuti.
Hindi lamang napabuti ng pagdaragdag ng blinatumomab sa chemotherapy ang pangkalahatang kaligtasan, ngunit ginawa rin nitong mas mahaba ang buhay ng mga pasyente nang hindi bumabalik ang kanilang kanser kumpara sa mga nakakuha lamang ng chemotherapy.
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.
