Dr. Brown on the Success of Blinatumomab in the AALL 1331 Trial

Patrick Brown, MD, chair of NCCN Guidelines for Adult and Pediatric ALL, and director of the Pediatric Leukemia Program at Sidney Kimmel Comprehensive Cancer Center, discusses the encouraging results of blinatumomab (Blincyto) in the AALL 1331 trial.

The randomized phase III Children’s Oncology Group Study evaluated blinatumomab versus chemotherapy as post-reinduction therapy in high- and intermediate-risk pediatric and young adults with B-acute lymphoblastic leukemia in first relapse. The major reason why outcomes were better on the blinatumomab arm is because it was better tolerated than intensive chemotherapy, says Brown.

For example, the rates of grade ≥3 adverse events were higher on the control arm than the blinatumomab arm (P <.001). However, blinatumomab does have associated toxicities, such as cytokine release syndrome and neurotoxicity. Similarly, rates of neurotoxicity were 10% to 15%, which is a relatively low grade and reversible.

In this study, blinatumomab proved to be superior to chemotherapy and plays a reason as to why patients could make it to the transplant phase and received curated therapy, concludes Brown.