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Blinatumomab vs historical standard therapy of adult relapsed/refractory acute lymphoblastic leukemia.

作者信息

Gökbuget N, Kelsh M, Chia V, Advani A, Bassan R, Dombret H, Doubek M, Fielding A K, Giebel S, Haddad V, Hoelzer D, Holland C, Ifrah N, Katz A, Maniar T, Martinelli G, Morgades M, O'Brien S, Ribera J-M, Rowe J M, Stein A, Topp M, Wadleigh M, Kantarjian H

机构信息

Department of Medicine, University Hospital, Goethe University, Frankfurt, Germany.

Center for Observational Research, Thousand Oaks, CA, Amgen, USA.

出版信息

Blood Cancer J. 2016 Sep 23;6(9):e473. doi: 10.1038/bcj.2016.84.


DOI:10.1038/bcj.2016.84
PMID:27662202
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5056974/
Abstract

We compared outcomes from a single-arm study of blinatumomab in adult patients with B-precursor Ph-negative relapsed/refractory acute lymphoblastic leukemia (R/R ALL) with a historical data set from Europe and the United States. Estimates of complete remission (CR) and overall survival (OS) were weighted by the frequency distribution of prognostic factors in the blinatumomab trial. Outcomes were also compared between the trial and historical data using propensity score methods. The historical cohort included 694 patients with CR data and 1112 patients with OS data compared with 189 patients with CR and survival data in the blinatumomab trial. The weighted analysis revealed a CR rate of 24% (95% CI: 20-27%) and a median OS of 3.3 months (95% CI: 2.8-3.6) in the historical cohort compared with a CR/CRh rate of 43% (95% CI: 36-50%) and a median OS of 6.1 months (95% CI: 4.2-7.5) in the blinatumomab trial. Propensity score analysis estimated increased odds of CR/CRh (OR=2.68, 95% CI: 1.67-4.31) and improved OS (HR=0.536, 95% CI: 0.394-0.730) with blinatumomab. The analysis demonstrates the application of different study designs and statistical methods to compare novel therapies for R/R ALL with historical data.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2e/5056974/cd226529c533/bcj201684f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2e/5056974/75316448f3a9/bcj201684f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2e/5056974/cd226529c533/bcj201684f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2e/5056974/75316448f3a9/bcj201684f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2e/5056974/cd226529c533/bcj201684f2.jpg

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本文引用的文献

[1]
International reference analysis of outcomes in adults with B-precursor Ph-negative relapsed/refractory acute lymphoblastic leukemia.

Haematologica. 2016-12

[2]
Acute lymphoblastic leukemia: an assessment of international incidence, survival, and disease burden.

Cancer Causes Control. 2015-11

[3]
FDA Approval: Blinatumomab.

Clin Cancer Res. 2015-9-15

[4]
The role of nonrandomized trials in the evaluation of oncology drugs.

Clin Pharmacol Ther. 2015-4-7

[5]
Safety and activity of blinatumomab for adult patients with relapsed or refractory B-precursor acute lymphoblastic leukaemia: a multicentre, single-arm, phase 2 study.

Lancet Oncol. 2014-12-16

[6]
Chimeric antigen receptor T cells for sustained remissions in leukemia.

N Engl J Med. 2014-10-16

[7]
Immunopharmacologic response of patients with B-lineage acute lymphoblastic leukemia to continuous infusion of T cell-engaging CD19/CD3-bispecific BiTE antibody blinatumomab.

Blood. 2012-5-16

[8]
Outcome of relapsed adult lymphoblastic leukemia depends on response to salvage chemotherapy, prognostic factors, and performance of stem cell transplantation.

Blood. 2012-4-4

[9]
Inotuzumab ozogamicin, an anti-CD22-calecheamicin conjugate, for refractory and relapsed acute lymphocytic leukaemia: a phase 2 study.

Lancet Oncol. 2012-2-21

[10]
Modern therapy of acute lymphoblastic leukemia.

J Clin Oncol. 2011-1-10

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