Blinatumomab after R-CHOP bridging therapy for patients with Richter transformation: a phase 2 multicentre trial

• DOI: 10.1038/s41467-024-51264-2
• Publication Date: 2024-08-09T15:03:00Z
• Authors: Romain Guièze; Loïc Ysebaert; Damien Roos-Weil; Luc-Mathieu Forne...; Emmanuelle Ferrant; Lysiane Molina; Thérèse Aurran; Aline Clavert; Sophie de Guibert; Anne-Sophie Micha...; Alain Saad; Bernard Drénou; Philippe Quittet; Bénédicte Hivert; Kamel Laribi; Julie Gay; Anne Quinquenel; Julien Broseus; Valérie Rouille; David Schwartz; Benoit Magnin; Grégory Lazarian; Lauren Véronèse; Marie de Antonio; Camille Laurent; Olivier Tournilhac; Bruno Pereira; Pierre Feugier
• Keywords: Blinatumomab

Richter transformation (RT) is an aggressive lymphoma occurring in patients with chronic lymphocytic leukaemia. Here we investigated the anti-CD3/anti-CD19 T-cell-engager blinatumomab after R-CHOP (i.e. rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) untreated RT of diffuse large B-cell histology (NCT03931642). In this multicentre phase 2 study, without complete response (CR) two cycles were eligible to receive 8-week induction via continuous vein infusion stepwise dosing until 112 μg/day. The primary endpoint was CR rate secondary included safety, duration, progression-free overall survival. Thirty-nine started first cycle R-CHOP, 25 whom received blinatumomab. After induction, five (20%) achieved CR, four (16%) partial response, six (24%) stable. Considering entire strategy, full-analysis-set 46% (n = 18), 14 (36%) patients. most common treatment-emergent adverse events all grades blinatumomab-safety-set fever (36%), anaemia (24%), lymphopaenia (24%). Cytokine release syndrome (grade 1/2) observed 16% neurotoxicity 20% Blinatumomab demonstrated encouraging anti-tumour activity (the trial met its endpoint) acceptable toxicity RT.