Targeted immunotherapy combination offers hope to older adults with leukemia

Researchers from the Alliance for Clinical Trials in Oncology have found that two targeted immunotherapy drugs lead to high remission rates and long survival with reasonable side effects for older patients with a tough-to-treat form of leukemia.

The results of Alliance A041703 Cohort 1, published in the Journal of Clinical Oncology, focused on treating patients aged 60 years and older with newly diagnosed B-cell acute lymphoblastic leukemia (ALL) with immunotherapy medications inotuzumab ozogamicin and blinatumomab. Historically, this group has faced poor outcomes with traditional chemotherapy due to high rates of treatment-related death and relapse.

“Our study shows that targeted immunotherapy is an excellent treatment option for older patients with acute lymphoblastic leukemia,” said Alliance study chair and lead author Matthew Wieduwilt, MD, Ph.D., Professor of Cancer Medicine at Wake Forest University School of Medicine. “This is a major step forward as we were able to effectively treat the leukemia without conventional chemotherapy, which is often too toxic for older adults.”

What the study found

• Who was treated: 33 patients, ages 60 to 84 years, with a specific type of leukemia (CD22-positive, Philadelphia chromosome-negative B-cell ALL).
• How they were treated: Patients received up to two cycles of inotuzumab ozogamicin, followed by four or five cycles of blinatumomab. Inotuzumab ozogamicin and blinatumomab are targeted immunotherapy cancer drugs. They work by finding leukemia cells in the body and targeting certain proteins on them, leading to the death of those cells, sparing healthy cells.
• Results:
  • 97% of patients went into remission.
  • 75% were alive and free of relapse one year after treatment.
  • 85% were still alive at one-year follow-up.

These results are significantly better than historical outcomes for this population. The treatment was generally well tolerated by participants, and more than half of them completed the full course of therapy.

The study also included patients who had previously been treated for other cancers, such as multiple myeloma or breast cancer. These individuals responded just as well to the new regimen, suggesting it could be a good option even for those with complex medical histories.

“Conventional systemic chemotherapy has long been the only option for treating Ph-negative ALL, but it can often be too toxic for older adults. This new approach of targeted immunotherapy may be a more effective approach while simultaneously being less toxic and taxing on the patient,” said Dr. Wieduwilt. “While more research in larger studies is needed to confirm these results, our study showcases how targeted therapies based on a patient’s specific cancer markers can effectively treat leukemia.”

Provided by
Alliance for Clinical Trials in Oncology