Subcutaneous Blinatumomab for Treatment of Adult Patients With CD19-Positive Mixed Phenotype Acute Leukemia (MPAL)

Conditions

• CD19 Positive
• Mixed Phenotype Acute Leukemia (MPAL)

Eligibility Criteria

Sex

ALL

Age

18 Years - N/A

Healthy Volunteers

Not accepted

Interventions

• Subcutaneous Blinatumomab — DRUG
  Blinatumomab will be administered as a subcutaneous (SC) injection.

Study Details

This is a multicenter, non-randomized, open-label, phase II study evaluating blinatumomab administered subcutaneously in adult subjects with CD19+ MPAL. This trial consists of three cohorts of patients with CD19-positive MPAL, categorized as follows: 1. Cohort A: Newly diagnosed CD19+ MPAL in untreated patients who are either ≥ 75 years of age or have at least one coexisting condition precluding intensive chemotherapy. 2. Cohort B: Patients with CD19+ MPAL who have achieved complete remission (CR, CRh, or CRi) following at least one line of treatment but have detectable measurable residual disease (MRD) at a level of ≥ 0.1%, assessed using an assay with a minimum sensitivity of 0.01%. 3. Cohort C: Patients with CD19+ MPAL with morphologic relapsed or refractory (R/R) disease following at least one prior line of treatment. The Primary Objectives for each cohort are for Cohort A: to evaluate the efficacy of SC-blinatumomab in treatment; for Cohort B: to assess the ability of SC-blinatumomab to achieve MRD-negative CR; for Cohort C: to determine the efficacy of SC-blinatumomab in inducing CR, CRh, or CRi in patients. At specified time points, subjects will undergo the following procedures: collection of informed consent, medical history, demographics, ECOG performance, and physical exam including vital signs as well as neurological examination including examination of writing ability. Subjects will provide samples for complete blood count with differential and blood chemistry profile, have a bone marrow aspiration and biopsy and lumbar puncture will be performed per protocol or if clinically indicated, and/or ECG, Echocardiography, pulmonary function test will be performed only if medically indicated. The subcutaneous treatment will be given in both the inpatient and outpatient setting. For an individual subject the length of participation includes up to a 3-week screening period, up to a 13-month treatment period, and a safety follow-up visit (30 days after the last dose of study treatment), and a follow-up period.

Key Dates

Start date

Jan 15, 2026

Status verified

Apr 2026

Primary completion

Aug 31, 2029

Completion

Aug 31, 2031

Study Design

Enrollment

78 participants (estimated)

Allocation

NON_RANDOMIZED

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Arms

• Experimental: Blinatumomab in Newly Diagnosed CD19+ MPAL, Age ≥ 75 or Unfit for Intensive Chemotherapy
  Cohort A: Evaluate the efficacy of SC-blinatumomab in treating newly diagnosed CD19+ MPAL in patients ≥ 75 years old or those deemed unfit for intensive chemotherapy. * Each cycle = 34 days (26-day treatment period + 8-day treatment free interval between day 27 and day 34). * Cycle 1 receives treatment daily during the first week and 3 times (TIW) weekly (M/W/F) during weeks 2-4. * In subsequent cycles, the treatment will be administered TIW during weeks 1-4. * All subjects will be hospitalized for days 1-12 of cycle 1. * Other treatment doses will be given as outpatients. Subjects will remain in the outpatient department for 1-6 hours after each dose is given. * Treatment will be given with ability to delay cycle initiation based on blood counts or general physical/neurological examination findings per clinical indication and institutional standard practice.
• Experimental: Blinatumomab use in CD19+ MPAL in first or second CR/CRh/CRi with detectable MRD ≥0.1%
  Cohort B: Assess the ability of SC-blinatumomab to achieve MRD-negative CR in patients with CD19+ MPAL in CR/CRh/CRi with persistent MRD positivity (≥ 0.1%) after at least one line of treatment. * Each cycle = 34 days (26-day treatment period + 8-day treatment free interval between day 27 and day 34). * Cycle 1 receives treatment daily during the first week and 3 times (TIW) weekly (M/W/F) during weeks 2-4. * In subsequent cycles, the treatment will be administered TIW during weeks 1-4. * All subjects will be hospitalized for days 1-12 of cycle 1. * Other treatment doses will be given as outpatients. Subjects will remain in the outpatient department for 1-6 hours after each dose is given. * Treatment will be given with ability to delay cycle initiation based on blood counts or general physical/neurological examination findings per clinical indication and institutional standard practice.
• Experimental: Blinatumomab use in Morphologic R/R CD19+ MPAL
  Cohort C: Determine the efficacy of SC-blinatumomab in inducing CR, CRh, or CRi in patients with morphologic relapsed or refractory CD19+ MPAL. * Each cycle = 34 days (26-day treatment period + 8-day treatment free interval between day 27 and day 34). * Cycle 1 receives treatment daily during the first week and 3 times (TIW) weekly (M/W/F) during weeks 2-4. * In subsequent cycles, the treatment will be administered TIW during weeks 1-4. * All subjects will be hospitalized for days 1-12 of cycle 1. * Other treatment doses will be given as outpatients. Subjects will remain in the outpatient department for 1-6 hours after each dose is given. * Treatment will be given with ability to delay cycle initiation based on blood counts or general physical/neurological examination findings per clinical indication and institutional standard practice.

Primary Outcome Measure

Cohort A - Overall Survival [ Time Frame: Up to 3 years ]

Central Contacts

• Ashkan Emadi, MD
  304-293-5949
  [email protected]
• Lindsay Carter
  304-293-5949
  [email protected]

Locations (1)

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