At 3.5 Years, 83% of Patients on BLINCYTO Plus Chemotherapy Were Alive Versus 65% of Patients on Chemotherapy Alone
Trial Design and Conduct Sponsored by the ECOG-ACRIN Cancer Research Group
THOUSAND OAKS, CA, USA I December 13, 2022 I Amgen (NASDAQ: AMGN) today announced the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) will present results from the E1910 randomized Phase 3 trial. This is the first study to demonstrate superior overall survival (OS) with BLINCYTO added to consolidation chemotherapy over current standard of care (multiagent consolidation chemotherapy) in newly diagnosed adult patients with Philadelphia chromosome-negative B-ALL who were measurable residual disease (MRD)-negative following induction and intensification chemotherapy. These results were featured in a press briefing on Monday, Dec. 12 at 8:30 a.m. CT and presented on Tuesday, Dec. 13 at 9 a.m. CT as a late breaking oral presentation (LBA1) at the 64th American Society of Hematology (ASH) Annual Meeting & Exposition in New Orleans.
“Treatment with BLINCYTO in addition to consolidation chemotherapy reduced the risk of death by 58% compared to chemotherapy alone. We are pleased by this remarkable improvement in overall survival, and we look forward to sharing these data with regulatory authorities as soon as possible,” said David M. Reese, M.D., executive vice president of Research and Development at Amgen. “Amgen continues to advance a robust development program for BLINCYTO, with a focus on minimizing chemotherapy and a subcutaneous formulation to help address remaining unmet needs for patients with B-ALL.”
The Phase 3 randomized trial (E1910), activated in December 2013, evaluated the safety and efficacy of BLINCYTO added to standard of care consolidation chemotherapy compared to chemotherapy alone in patients with newly diagnosed B-ALL with no MRD after induction and intensification chemotherapy. The primary endpoint was OS and key secondary endpoints included relapse-free survival, MRD status, and incidence of adverse events. Based on a recommendation by the ECOG-ACRIN Data Safety Monitoring Committee and consistent with the pre-defined efficacy threshold, results from the planned interim analysis are now reported due to overwhelming efficacy reported in the BLINCYTO arm.
With a median follow up of 43 months, the study met its primary endpoint with a significant improvement in overall survival favoring the BLINCYTO arm; median OS was not reached vs. 71.4 months in the control arm (hazard ratio [HR] = 0.42, 95% CI: 0.24 – 0.75; two-sided p=0.003). After about 3.5 years of follow-up, 83% of the patients who went on to receive additional standard consolidation chemotherapy plus experimental BLINCYTO were alive versus 65% of those who received chemotherapy only. No new safety signals were reported for the combination.
“Adults with newly diagnosed ALL can achieve a high rate of complete remission with chemotherapy, but frequently relapse and have disappointing survival rates.1,2 Historically, outcomes for newly diagnosed adults with ALL have been significantly worse than for children, where up to 90% of patients are cured with frontline therapy.3,4 In this study, survival rates for adults when blinatumomab was added to chemotherapy are significantly improved in patients with MRD-negative remission, approaching those we have seen in children,” said Selina M. Luger, M.D., professor of hematology-oncology at the University of Pennsylvania’s Abramson Cancer Center and Perelman School of Medicine, chair of the ECOG-ACRIN Leukemia Committee and an investigator on the study. “Moreover, the data provide additional clinical evidence supporting the recent guideline updates for adult ALL recommending blinatumomab as consolidation in both MRD-positive and MRD-negative patients.”
Data from the trial will be submitted to global regulatory authorities, including where BLINCYTO has been previously approved.
Study E1910 was designed and conducted independently from industry with public funding. The ECOG-ACRIN Cancer Research Group sponsored the trial with funding from the National Cancer Institute (NCI), part of the National Institutes of Health. Other NCI-funded network groups took part in the study. In addition, Amgen provided BLINCYTO and support through an NCI Cooperative Research and Development Agreement (CRADA).
E1910 Study Design
In the E1910 Phase 3 randomized trial, 488 patients aged 30-70 with newly diagnosed B-ALL were enrolled. All participants initially received 2.5 months of combination induction chemotherapy (step 1). After remission induction (step 1), if patients were in complete remission, they continued on-study and received an intensification course of high dose chemotherapy (step 2). Subsequently, their remission and MRD status were determined. All patients were then randomized/assigned to receive four cycles of consolidation chemotherapy with or without four 28-day cycles of BLINCYTO (step 3). Following FDA approval of blinatumomab for MRD-positive patients in March 2018, MRD-positive participants were assigned to the blinatumomab arm. MRD-negative patients continued to be randomized. After completion of consolidation chemo +/- BLINCYTO, patients were given 2.5 years of chemotherapy maintenance therapy timed from the start of the intensification cycle (step 4).
For more information, please visit ClinicalTrials.gov.
About BLINCYTO® (blinatumomab)
BLINCYTO is a BiTE® (bispecific T-cell engager) immuno-oncology therapy that targets CD19 surface antigens on B cells. BiTE molecules fight cancer by helping the body’s immune system detect and target malignant cells by engaging T cells (a type of white blood cell capable of killing other cells perceived as threats) to cancer cells. By bringing T cells near cancer cells, the T cells can inject toxins and trigger cancer cell death (apoptosis). BiTE immuno-oncology therapies are currently being investigated for their potential to treat a wide variety of cancers.
BLINCYTO was granted breakthrough therapy and priority review designations by the U.S. Food and Drug Administration and is approved in the U.S. for the treatment of:
- relapsed or refractory CD-19 positive B-cell precursor ALL in adults and children.
- CD-19 positive B-cell precursor ALL in first or second complete remission with minimal residual disease (MRD) greater than or equal to 0.1% in adults and children. This indication is approved under accelerated approval based on MRD response rate and hematological relapse-free survival. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.
In the European Union (EU), BLINCYTO is indicated as monotherapy for the treatment of:
- adults with Philadelphia chromosome negative CD19 positive relapsed or refractory B-precursor acute lymphoblastic leukemia (ALL).
- adults with Philadelphia chromosome negative CD19 positive B-precursor ALL in first or second complete remission with minimal residual disease (MRD) greater than or equal to 0.1%.
- pediatric patients aged 1 year or older with Philadelphia chromosome negative CD19 positive B-precursor ALL which is refractory or in relapse after receiving at least two prior therapies or in relapse after receiving prior allogeneic hematopoietic stem cell transplantation
Please see full Prescribing Information and medication guide for BLINCYTO at www.BLINCYTO.com.
About BiTE® Technology
BiTE® (bispecific T cell engager) technology is a targeted immuno-oncology platform that is designed to engage patient’s own T cells to any tumor-specific antigen, activating the cytotoxic potential of T cells to eliminate detectable cancer. The BiTE immuno-oncology platform has the potential to treat different tumor types through tumor-specific antigens. The BiTE platform has a goal of leading to off-the-shelf solutions, which have the potential to make innovative T cell treatment available to all providers when their patients need it. Amgen is advancing more than a dozen BiTE molecules across a broad range of hematologic malignancies and solid tumors, further investigating BiTE technology with the goal of enhancing patient experience and therapeutic potential. To learn more about BiTE technology, visit www.AmgenBiTETechnology.com.
About Amgen Oncology
At Amgen Oncology, our mission to serve patients drives all that we do. That’s why we’re relentlessly focused on accelerating the delivery of medicines that have the potential to empower all angles of care and transform lives of people with cancer.
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SOURCE: Amgen