TY - JOUR
T1 - Sequencing of novel agents in relapsed/refractory B-cell acute lymphoblastic leukemia
T2 - Blinatumomab and inotuzumab ozogamicin may have comparable efficacy as first or second novel agent therapy in relapsed/refractory acute lymphoblastic leukemia
AU - Badar, Talha
AU - Szabo, Aniko
AU - Dinner, Shira
AU - Liedtke, Michaela
AU - Burkart, Madelyn
AU - Shallis, Rory M.
AU - Yurkiewicz, Ilana R.
AU - Kuo, Eric
AU - Khan, Muhammad Ali
AU - Balasubramanian, Suresh
AU - Yang, Jay
AU - Hefazi, Mehrdad
AU - Podoltsev, Nikolai
AU - Patel, Anand
AU - Curran, Emily
AU - Wang, Amy
AU - Arslan, Shukaib
AU - Aldoss, Ibrahim
AU - Siebenaller, Caitlin
AU - Mattison, Ryan J.
AU - Litzow, Mark R.
AU - Wadleigh, Martha
AU - Advani, Anjali S.
AU - Atallah, Ehab
N1 - Funding Information:
Caitlin Siebenaller reports personal fees from Novartis outside the submitted work. Ryan J. Mattison has served on an advisory board for Pfizer. Mark R. Litzow reports grants from Amgen during the conduct of the study. Nikolai Podoltsev reports receiving honoraria/serving as a consultant for Alexion, Pfizer, Agios Pharmaceuticals, Blueprint Medicines, Incyte, Novartis, Celgene, Bristol‐Myers Squib, CTI Biopharma, and Pharma Essentials; receiving research funding (for his institution) from Boehringer Ingelheim, Astellas Pharma, Daiichi Sankyo, Sunesis Pharmaceuticals, Jazz Pharmaceuticals, Pfizer, Astex Pharmaceuticals, CTI Biopharma, Celgene, Genentech, AI Therapeutics, Samus Therapeutics, Arog Pharmaceuticals, and Kartos Therapeutics; receiving grant funding from Celgene; and receiving personal fees from Celgene and Novartis. Anjali S. Advani reports receiving honoraria/serving as a consultant for GlycoMimetics, Kite Pharmaceuticals, Novartis, and Pfizer; she also reports receiving research support from Amgen, AbbVie, Macrogenics, GlycoMimetics, and Pfizer. The other authors made no disclosures.
Publisher Copyright:
© 2020 American Cancer Society
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Background: The availability of novel agents (NAs), including blinatumomab and inotuzumab ozogamicin (InO), has improved the outcomes of patients with relapsed/refractory (RR) B-cell acute lymphoblastic leukemia (ALL). Because of the relative effectiveness, it is often a challenge for clinicians to determine how to best sequence these NAs with respect to efficacy and toxicity. Methods: In this multicenter, retrospective study of patients with RR ALL treated with blinatumomab, InO, or both, their efficacy as a first or second NA was compared. Results: Among 276 patients, 221 and 55 received blinatumomab and InO, respectively, as a first NA therapy. The complete remission (CR)/complete remission with incomplete count recovery (CRi) rate was 65% and 67% for the blinatumomab and InO groups, respectively (P =.73). The rate of treatment discontinuation due to adverse events was 4% and 7% in the blinatumomab and InO groups, respectively. Ninety-two patients (43%) in the blinatumomab group and 13 patients (29%) in the InO group proceeded with allogeneic hematopoietic stem cell transplantation. The median overall survival (OS) was 15 and 11.6 months in the blinatumomab and InO groups, respectively. A subset analysis was performed for 61 patients who received both NAs (blinatumomab and then InO [n = 40] or InO and then blinatumomab [n = 21]). The CR/CRi rate was 58% for patients who received InO as the second NA and 52% for patients who received blinatumomab as the second NA. The median OS was 10.5 for patients who received InO as the second NA and 5.9 months for patients who received blinatumomab as the second NA (P =.09). Conclusions: Although the limited power of this study to detect a significant difference between subgroups is acknowledged, the data suggest that blinatumomab and InO may have comparable efficacy as a first or second NA therapy in RR ALL.
AB - Background: The availability of novel agents (NAs), including blinatumomab and inotuzumab ozogamicin (InO), has improved the outcomes of patients with relapsed/refractory (RR) B-cell acute lymphoblastic leukemia (ALL). Because of the relative effectiveness, it is often a challenge for clinicians to determine how to best sequence these NAs with respect to efficacy and toxicity. Methods: In this multicenter, retrospective study of patients with RR ALL treated with blinatumomab, InO, or both, their efficacy as a first or second NA was compared. Results: Among 276 patients, 221 and 55 received blinatumomab and InO, respectively, as a first NA therapy. The complete remission (CR)/complete remission with incomplete count recovery (CRi) rate was 65% and 67% for the blinatumomab and InO groups, respectively (P =.73). The rate of treatment discontinuation due to adverse events was 4% and 7% in the blinatumomab and InO groups, respectively. Ninety-two patients (43%) in the blinatumomab group and 13 patients (29%) in the InO group proceeded with allogeneic hematopoietic stem cell transplantation. The median overall survival (OS) was 15 and 11.6 months in the blinatumomab and InO groups, respectively. A subset analysis was performed for 61 patients who received both NAs (blinatumomab and then InO [n = 40] or InO and then blinatumomab [n = 21]). The CR/CRi rate was 58% for patients who received InO as the second NA and 52% for patients who received blinatumomab as the second NA. The median OS was 10.5 for patients who received InO as the second NA and 5.9 months for patients who received blinatumomab as the second NA (P =.09). Conclusions: Although the limited power of this study to detect a significant difference between subgroups is acknowledged, the data suggest that blinatumomab and InO may have comparable efficacy as a first or second NA therapy in RR ALL.
KW - allogeneic hematopoietic stem cell transplantation (allo-HCT)
KW - blinatumomab
KW - inotuzumab ozogamicin
KW - relapsed/refractory (RR) acute lymphoblastic leukemia (ALL)
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U2 - 10.1002/cncr.33340
DO - 10.1002/cncr.33340
M3 - Article
C2 - 33259056
AN - SCOPUS:85096971225
SN - 0008-543X
VL - 127
SP - 1039
EP - 1048
JO - Cancer
JF - Cancer
IS - 7
ER -