Meta-analysis: blinatumomab safe, effective in ALL, NHL

  • Yu J & al.
  • Hematology
  • 1 Dec 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Meta-analysis suggests blinatumomab, a bispecific T-cell engager antibody, is safe, effective in relapsed/refractory acute lymphoblastic leukemia (ALL) and non-Hodgkin’s lymphoma (NHL).
  • The response rate was higher in patients with ALL with lower tumor load.

Why this matters

  • Patients with relapsed/refractory ALL or NHL have a poor prognosis.

Study design

  • Meta-analysis of 8 studies including 729 patients with refractory/ relapsed ALL (n=628) and NHL (n=101).
  • Funding: The National Key Basic Research Program of China.

Key results

  • Blinatumomab achieved pooled complete remission (CR) rate of
    • 45% in patients with ALL (effect size [ES], 0.45; 95% CI, 0.37-0.53) and
    • 20% in patients with NHL (ES, 0.20; 95% CI, 0.12-0.27).
  • CR rate was higher in patients with bone marrow blast
  • History of allogenic-hematopoietic stem cell transplantation did not affect CR rate.
  • 23.6% of patients with ALL and 2.6% with NHL proceeded to allogeneic HSCT after blinatumomab treatment.
  • In patients with ALL, the minimal residual disease rate was 42% (ES, 0.42; 95% CI, 0.29-0.54).
  • Pooled rate of grade ≥3 cytokine release syndrome was 4% and that of neurological events was 12%.

Limitations

  • Small sample size, high heterogeneity.
  • Random effects model may minimize the inherent variances.