Survival outcomes and remission rates in adults aged 60 years and older diagnosed with B-cell acute lymphoblastic leukemia (ALL) remain poor. Over the last three decades, the mainstay treatment option for patients with B-cell ALL has been conventional chemotherapy. However, it has only provided modest improvements among patients 60 to 65 years of age and little to no improvement among patients aged 70 years and older. Most older patients have poor tolerance for these conventional chemotherapies.
Matthew Wieduwilt, MD, PhD, of Wake Forest University School of Medicine in North Carolina, will present the results of the Phase II Alliance A041703 study of a non-chemotherapy combination therapy for older adults with newly diagnosed CD22+, Ph-negative B-cell ALL on June 2 at the American Society of Clinical Oncology (ASCO) Annual Meeting. The single-arm study tested induction with inotuzumab ozogamicin, an anti-CD22-targeted antibody-drug conjugate followed by consolidation with blinatumomab, an anti-CD3/CD19 bifunctional T-cell engager (BiTE).
“Our hypothesis was that this regimen would have curative potential with high complete remission rates and very low rates of treatment-related death and death in remission,” Dr. Wieduwilt said.
Dr. Wieduwilt will present the study’s primary endpoint, one-year event-free survival, as well as response and overall survival outcomes. The study is the first to test these two U.S. Food and Drug Administration-approved agents together in B-cell ALL without the use of any conventional systemic chemotherapies.
“The results will provide a groundwork to improve treatment for older patients with ALL and could also improve outcomes of younger patients for whom this approach could be applied in sequence with conventional chemotherapy,” added Dr. Wieduwilt.
Any conflicts of interest declared by the authors can be found in the original abstract.
Reference
Wieduwilt MJ, Yin J, Kour O, et al. Chemotherapy-free treatment with inotuzumab ozogamicin and blinatumomab for older adults with newly diagnosed, Ph-negative, CD22-positive, B-cell acute lymphoblastic leukemia: Alliance A041703. Abstract 7006. Presented at the ASCO Annual Meeting, June 2, 2023; Chicago, Illinois.