Blinatumomab for the treatment of acute lymphoblastic leukemia: an update

Introduction: Blinatumomab is a first-in-class bispecific T-cell engager (BiTE) antibody that has demonstrated high response rates, including minimal or measurable residual disease (MRD) negativity, in the treatment of acute lymphoblastic leukemia (ALL). As a single agent, blinatumomab has demonstrated significant activity in patients with both relapsed/refractory Philadelphia chromosome-negative and Philadelphia chromosome-positive disease and in patients with persistent MRD. Its unique mechanism of action accounts for its ability to induce durable responses as well as its side effect profile. Areas covered: This manuscript will review the place in therapy for blinatumomab as well as the phase I, phase II, and phase III clinical trials which led to its development and FDA approval for the treatment of ALL. Expert opinion: Blinatumomab is a welcomed addition to the available treatment options for patients with relapsed or refractory ALL. Furthermore, it is currently the most effective treatment in eradicating MRD, and subsequently allowing patients to proceed to allogeneic stem cell transplantation. Improved efficacy is observed in patients treated earlier and in those with lower disease burden, therefore continued evaluation of blinatumomab in combination with chemotherapy in the frontline treatment setting is essential.