One monoclonal antibody is currently approved for the treatment of acute lymphoblastic leukemia (ALL).
Approved immunotherapeutic agents
Combination therapy/treatment algorithms
Approved immunotherapeutic agents (for acute lymphoblastic leukemia)
In 2014, blinatumomab (Blincyto, Amgen) was approved for the treatment of relapsed or refractory ALL that is negative for the Philadelphia chromosome, a fusion gene that is the result of a translocation between chromosomes 9 and 22; this gene occurs in less than 2% of patients with ALL (Figure 4). Blinatumomab is a bispecific monoclonal antibody, or a bispecific T-cell engager, that contains antibodies to both CD19, a surface marker found on B lymphocytes, and CD3, a surface antigen on cytotoxic T lymphocytes.
Figure 4. The Philadelphia chromosome.
Acute lymphoblastic leukemia combination therapy/treatment algorithms
Blinatumomab is the preferred therapy for relapsed or refractory Philadelphia chromosome–negative B-cell ALL. Blinatumomab is not recommended in combination with other therapies.
Current clinical trials for acute lymphoblastic leukemia
Inotuzumab ozogamicin (CMC-544, Pfizer), an anti-CD22 monoclonal antibody-drug conjugate, was assigned breakthrough therapy status in late 2015 for the treatment of relapsed or refractory CD22-positive ALL.