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Brief Title: Clinical Study With Blinatumomab in Patients With Relapsed/Refractory B-precursor Acute Lymphoblastic Leukemia (ALL)
Official Title: An Open Label, Multicenter, Phase II Study to Evaluate Efficacy and Safety of the BiTE® Antibody Blinatumomab in Adult Patients With Relapsed/Refractory B-precursor Acute Lymphoblastic Leukemia (ALL)
Study ID: NCT01466179
Brief Summary: The purpose of this study is to confirm whether the bispecific T cell engager antibody blinatumomab (MT103) is effective and safe in the treatment of patients with relapsed or refractory Acute Lymphoblastic Leukemia (ALL).
Detailed Description: Relapsed/refractory B-precursor ALL in adult patients is an aggressive malignant disease with dismal prognosis. Several studies have reported long term survival to be below 10%. Major prognostic factors are duration of first complete remission (CR1) and age. With current salvage chemotherapy, complete remission (CR) rate is low (20 to 30%) in patients in first salvage with short duration (\< one year) of first remission, patients relapsed after first salvage, or patients aged 60 years and older. Duration of CR is usually very short (median disease free survival \[DFS\]: 2.0-7.5 months). Allogeneic hematopoietic stem cell transplantation (HSCT) may provide a curative treatment option for patients in CR with a satisfactory donor and appropriate clinical status including age, organ function, and remission status. Allogeneic HSCT is not an option in most elderly patients with relapsed ALL. Additional therapeutic approaches are urgently needed. Blinatumomab is a bispecific single-chain antibody derivative against CD (cluster of differentiation)19 and CD3, designed to link B cells and T cells resulting in T cell activation and a cytotoxic T cell response against CD19-expressing cells. In vitro data indicate CD19+ lymphoma and leukemia cell lines to be extremely sensitive to blinatumomab-mediated cytotoxicity. Blinatumomab has the potential to provide meaningful therapeutic benefits to patients compared with existing treatments for this patient population. This study consists of a screening period, a treatment period and a follow-up period. Participants receive one to five treatment cycles of blinatumomab at a target dose of 28 μg/day. In the first cycle, the initial dose is 9 μg/day for the first seven days of treatment, escalated to 28 μg/day starting from Week 2 of treatment. Participants who achieve remission within two cycles of treatment can receive up to three additional cycles of consolidation treatment or proceed to allogeneic HSCT. In the event of progression or relapse within the treatment period, treatment will be terminated. Participants with hematological relapse during the efficacy or safety follow-up period may receive up to three additional cycles of blinatumomab (retreatment) for a maximal total of eight cycles at the investigator´s discretion. Thirty days after end of the last treatment, participants have an end-of-core-study visit. Following this, there are efficacy follow-up visits at 3, 6, 9, 12, 18 and 24 months at the most after treatment start. Once efficacy follow-up is complete, information on survival collected at least every six months until death or at least until three years after treatment start, whichever occurs earlier (survival follow-up).
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
City of Hope, Duarte, California, United States
University of California Los Angeles, Los Angeles, California, United States
Winship Cancer Institute of Emory University, Atlanta, Georgia, United States
Rush University Medical Center, Chicago, Illinois, United States
University of Chicago, Chicago, Illinois, United States
Dana Farber Institute, Boston, Massachusetts, United States
Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States
Mayo Clinic, Rochester, Minnesota, United States
Washington University School of Medicine, Saint Louis, Missouri, United States
Roswell Park Cancer Streets, Buffalo, New York, United States
University of Pennsylvania, Philadelphia, Pennsylvania, United States
University of Texas MD Anderson Cancer Center, Houston, Texas, United States
CHU d'Angers, Angers, , France
Hôpital de l'hôtel Dieu, Nantes, , France
Hôpital Saint Louis, Paris, , France
CHU de Purpan, Toulouse, , France
Charité - Campus Benjamin Franklin, Berlin, , Germany
Klinikum der Goethe Universität, Medizinische Klinik II, Frankfurt, , Germany
Universitätsklinikum Freiburg, Freiburg, , Germany
Medizinische Hochschule Hannover, Hannover, , Germany
Universitätsklinikum Schleswig-Holstein, Kiel, , Germany
Universitätsklinikum Münster, Münster, , Germany
Universitätsklinikum Tübingen, Tübingen, , Germany
Universitätsklinikum Ulm, Ulm, , Germany
Julius-Maximilians-Universität, Medizinische Klinik und Poliklinik II, Würzburg, , Germany
Ospedali Riuniti di Bergamo, Bergamo, , Italy
Azienda Ospedaliera Antonio Cardarelli, Naples, , Italy
Ospedali Riuniti "Villa Sofia-Cervello", Palermo, , Italy
Università La Sapienza di Roma, Rome, , Italy
Azienda Ospedaliero-Universitaria, Turin, , Italy
Azienda Ospedaliera di Verona, Verona, , Italy
ICO Hospital Germans Trias I Pujol, Badalona, , Spain
Hospital Clínic Servei d´Hematologia, Barcelona, , Spain
Hospital 12 de Octubre, Madrid, , Spain
Hospital universitario de Salamanca, Salamanca, , Spain
Hospital Universitario Virgen Del Rocio, Sevilla, , Spain
University Hospitals Bristol NHS, Bristol, , United Kingdom
Royal Free Hampstead NHS Trust, London, , United Kingdom
The Christie NHS Foundation Trust, Manchester, , United Kingdom
Name: Nicola Gökbuget, MD
Affiliation: Klinikum der Goethe Universität Frankfurt
Role: PRINCIPAL_INVESTIGATOR
Name: Max Topp, MD
Affiliation: Julius-Maximilians-Universität, Medizinische Klinik und Poliklinik II, Würzburg
Role: PRINCIPAL_INVESTIGATOR
Name: Hagop Kantarjian, MD
Affiliation: MD Anderson Cancer Center, Houston, Texas
Role: PRINCIPAL_INVESTIGATOR