Multinational phase 3 trial of blinatumomab for MRD-negative acute lymphoblastic leukemia in adults

Many adults with B-cell precursor acute lymphoblastic leukemia (BCP-ALL) have a relapse despite having a measurable residual disease (MRD)-negative complete remission with combination chemotherapy. The multinational phase 3 E1910 trial evaluated addition of blinatumomab to consolidation chemotherapy in adult (aged 30-70 years) patients in MRD-negative remission from BCP-ALL. Patients were randomized to blinatumomab plus consolidation chemotherapy (n=112) or consolidation chemotherapy alone (n=112). Median duration of follow-up was 43 months. The 3-year overall survival rate was 85% with the blinatumomab plus chemotherapy versus 68% with chemotherapy alone (HR 0.41; p=0.002) and the 3-year relapse-free survival rate was 80% with blinatumomab plus chemotherapy versus 64% with chemotherapy alone (HR 0.53; 95% CI 0.32-0.87). A higher incidence of neuropsychiatric events was reported in the blinatumomab plus chemotherapy group than in the chemotherapy alone group (grade 3-5: 23% versus 5%). The authors conclude that the addition of blinatumomab to consolidation chemotherapy in adult patients in MRD-negative remission from BCP-ALL significantly improved overall survival.