Balancing toxicity and effectiveness in older adults with B-cell acute lymphocytic leukaemia
Mené sur 80 patients atteints d'une leucémie lymphoïde aiguë Ph- à cellules B (âge médian : 68 ans ; durée médiane de suivi : 92,8 mois), cet essai de phase II évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité de l'inotuzumab ozogamicine, avec ou sans blinatumomab, en combinaison avec une chimiothérapie de faible intensité
Older adults with acute lymphocytic leukaemia have historically had poor outcomes when treated with conventional chemotherapy, with 5-year survival less than 20%. Numerous factors contribute to this low survival rate, including adverse disease biology among older patients, but a major issue is poor tolerance to intensive chemotherapy regimens and high rates of treatment-related mortality. Attempts to decrease the intensity of chemotherapy have improved treatment-related mortality, but a trade-off associated with this approach is higher rates of relapse. Thus, several groups are investigating the use of novel agents for the upfront treatment of older adults with B-cell acute lymphocytic leukaemia, including inotuzumab ozogamicin, an antibody–drug conjugate targeted to CD22, and blinatumomab, a bi-specific T-cell engager targeted to CD19 and CD3, with the hope of minimising treatment-related mortality without sacrificing effectiveness.