Blinatumomab for treating acute lymphoblastic leukemia

Introduction: Immunotherapy is a promising modality of treatment for neoplastic diseases. The CD19/CD3-bispecific T cell-engaging (BiTE (R)) monoclonal antibody blinatumomab can transiently engage any cytotoxic T cells to CD19(+) target B cells inducing their serial lysis. Blinatumomab has shown promising activity in B-cell non-Hodgkin's lymphomas and, especially, in B-cell precursor acute lymphoblastic leukemia (ALL). Areas covered: This review focuses on the chemistry, pharmacological properties, clinical activity as well as the safety and tolerability of blinatumomab used in the treatment of relapsed/refractory (R/R) (including minimal residual disease-positive [MRD+]) ALL in adults and children. Expert opinion: Blinatumomab has demonstrated encouraging response rates in the setting of MRD+ and in R/R ALL in adults and children. Blinatumomab has a favorable safety profile, although reversible CNS events and cytokine release syndrome can occur. Encouraging reports on the activity of blinatumomab in the R/R B-cell precursor ALL led to its approval by the US FDA after an accelerated review process on 3 December 2014.