WolverHeme Happy Hour Episode 32: Navigating a BlinatumoMAD World
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Jan 21, 2025 Join Julia Brown, PharmD, a pediatric hematology/oncology pharmacist, and Lydia Benitez, an adult leukemia pharmacist, as they dive into the evolving landscape of blinatumomab in acute lymphoblastic leukemia (ALL). They discuss the impactful findings of the AALL1731 trial and ECOG-1910, shedding light on improved survival rates. The conversation touches on practical challenges like home infusion, patient monitoring strategies, and the exciting potential of subcutaneous formulations, all while emphasizing equitable access for vulnerable populations.
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Use Blinatumomab Broadly In Adults
- Adopt blinatumomab broadly for adult B-ALL patients, MRD positive or negative, based on ECOG-1910 published survival benefit.
- Implement after consolidation as in the trial and avoid extending maintenance beyond the trial's schedule.
Pediatric Evidence Now Supports Targeted Use
- Pediatric blinatumomab data matured later but now supports strong benefit in specific subgroups like infants and certain SR patients.
- The trial design used high-sensitivity NGS MRD to identify SR-average kids who then received blinatumomab in consolidation.
Apply Trial Maintenance Timing
- Consider blinatumomab for SR-average pediatric patients with NGS-detectable MRD to reduce relapse risk.
- Shorten maintenance to mirror trial schedules when adding blinatumomab to avoid overtreatment.