PMID- 25385737 OWN - NLM STAT- MEDLINE DCOM- 20150223 LR - 20210103 IS - 1527-7755 (Electronic) IS - 0732-183X (Linking) VI - 32 IP - 36 DP - 2014 Dec 20 TI - Phase II trial of the anti-CD19 bispecific T cell-engager blinatumomab shows hematologic and molecular remissions in patients with relapsed or refractory B-precursor acute lymphoblastic leukemia. PG - 4134-40 LID - 10.1200/JCO.2014.56.3247 [doi] AB - PURPOSE: Patients with relapsed or refractory acute lymphoblastic leukemia (ALL) have a dismal prognosis. CD19 is homogenously expressed in B-precursor ALL and can be targeted by the investigational bispecific T cell-engager antibody blinatumomab. A phase II trial was performed to determine clinical activity in this patient cohort. PATIENTS AND METHODS: Thirty-six patients with relapsed or refractory B-precursor ALL were treated with blinatumomab in cycles of 4-week continuous infusion followed by a 2-week treatment-free interval in a single-arm study with a dose-finding stage and an extension stage. The primary end point was complete remission (CR) or CR with partial hematologic recovery (CRh). Major secondary end points included minimal residual disease (MRD) response, rate of allogeneic hematopoietic stem-cell transplantation (HSCT) realization, relapse-free survival (RFS), overall survival (OS), and incidence of adverse events (AEs). RESULTS: Median age was 32 years (range, 18 to 77 years). Twenty-five patients (69%) achieved a CR or CRh, with 88% of the responders achieving an MRD response. Median OS was 9.8 months (95% CI, 8.5 to 14.9), and median RFS was 7.6 months (95% CI, 4.5 to 9.5). Thirteen responders (52%) underwent HSCT after achieving a CR or CRh. The most frequent AE during treatment was pyrexia (grade 1 or 2, 75%; grade 3, 6%). In six patients with nervous system or psychiatric disorder AEs and in two patients with cytokine release syndrome, treatment had to be interrupted or discontinued. These medical events were resolved clinically. CONCLUSION: The data support further investigation of blinatumomab for the treatment of adult patients with relapsed or refractory ALL in a larger confirmatory study. CI - (c) 2014 by American Society of Clinical Oncology. FAU - Topp, Max S AU - Topp MS AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. topp_m@ukw.de. FAU - Gokbuget, Nicola AU - Gokbuget N AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Zugmaier, Gerhard AU - Zugmaier G AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Klappers, Petra AU - Klappers P AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Stelljes, Matthias AU - Stelljes M AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Neumann, Svenja AU - Neumann S AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Viardot, Andreas AU - Viardot A AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Marks, Reinhard AU - Marks R AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Diedrich, Helmut AU - Diedrich H AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Faul, Christoph AU - Faul C AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Reichle, Albrecht AU - Reichle A AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Horst, Heinz-August AU - Horst HA AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Bruggemann, Monika AU - Bruggemann M AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Wessiepe, Dorothea AU - Wessiepe D AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Holland, Chris AU - Holland C AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Alekar, Shilpa AU - Alekar S AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Mergen, Noemi AU - Mergen N AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Einsele, Hermann AU - Einsele H AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Hoelzer, Dieter AU - Hoelzer D AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. FAU - Bargou, Ralf C AU - Bargou RC AD - Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Universitatsklinikum Wurzburg, Wurzburg; Nicola Gokbuget, Goethe University; Dieter Hoelzer, Onkologikum, Frankfurt; Gerhard Zugmaier, Petra Klappers, and Noemi Mergen, Amgen Research; Dorothea Wessiepe, Metronomia, Munich; Matthias Stelljes, University of Munster, Munster; Svenja Neumann, Heinz-August Horst, and Monika Bruggemann, University Schleswig Holstein, City Hospital, Kiel; Andreas Viardot, University of Ulm, Ulm; Reinhard Marks, Universitatsklinikum Freiburg, Freiburg; Helmut Diedrich, Medizinische Hochschule Hannover, Hannover; Christoph Faul, Universitatsklinikum Tubingen, Tubingen; Albrecht Reichle, Universitatsklinikum Regensburg, Regensburg, Germany; and Chris Holland and Shilpa Alekar, Amgen, Rockville, MD. LA - eng SI - ClinicalTrials.gov/NCT01209286 PT - Clinical Trial, Phase II PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20141110 PL - United States TA - J Clin Oncol JT - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JID - 8309333 RN - 0 (Antibodies, Bispecific) RN - 4FR53SIF3A (blinatumomab) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Antibodies, Bispecific/adverse effects/*therapeutic use MH - Female MH - Hematopoietic Stem Cell Transplantation MH - Humans MH - Male MH - Middle Aged MH - Neoplasm, Residual MH - Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/blood/*drug therapy/mortality MH - Recurrence MH - Remission Induction EDAT- 2014/11/12 06:00 MHDA- 2015/02/24 06:00 CRDT- 2014/11/12 06:00 PHST- 2014/11/12 06:00 [entrez] PHST- 2014/11/12 06:00 [pubmed] PHST- 2015/02/24 06:00 [medline] AID - JCO.2014.56.3247 [pii] AID - 10.1200/JCO.2014.56.3247 [doi] PST - ppublish SO - J Clin Oncol. 2014 Dec 20;32(36):4134-40. doi: 10.1200/JCO.2014.56.3247. Epub 2014 Nov 10.