A Study of Subcutaneous Blinatumomab Administration in Participants With R/R and MRD+ B-ALL

NCT ID: NCT04521231

Last Updated: 2025-11-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

281 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-04

Study Completion Date

2029-05-25

Brief Summary

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The Phase I part of the study aims to evaluate the safety, efficacy, and tolerability of subcutaneous (SC) blinatumomab for treatment of Relapsed or Refractory B cell Precursor Acute Lymphoblastic Leukemia (R/R B-ALL), to determine the maximum tolerated dose (MTD), and recommended phase 2 dose(s) (RP2D) of SC administered blinatumomab.

The Phase II part of the study will evaluate the safety, efficacy, and tolerability of SC blinatumomab for treatment of R/R B-ALL and Minimum Residual Disease Positive (MRD+) B-ALL in participants 12 years old and greater. It will also conduct a clinical pharmacokinetic (PK) evaluation of SC1 and SC2 blinatumomab formulations.

Detailed Description

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Conditions

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B Cell Precursor Acute Lymphoblastic Leukemia

Keywords

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R/R B-ALL MRD+ B-ALL Relapsed Refractory Minimal Residual Disease AMG 103 Blinatumomab Acute lymphoblastic leukemia Adolescent Adult

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dose Escalation Phase: Blinatumomab Subcutaneous Formulation 1 (SC1)

Cohorts of at least 3 adult participants with R/R B-ALL will be treated with escalating doses of blinatumomab to determine the maximum tolerated dose (MTD). The MTD will be defined as the dose for which the estimate of the toxicity rate from an isotonic regression (Yan et al, 2017) is closest to the target toxicity rate. Safety, pharmacokinetics (PK), pharmacodynamics (PD) and efficacy will be assessed.

Group Type EXPERIMENTAL

Blinatumomab

Intervention Type DRUG

Blinatumomab will be administered as a subcutaneous (SC) injection.

Dose Expansion Phase: Blinatumomab SC1

Up to 4 cohorts of adult participants with R/R B-ALL will be enrolled at different dose levels to support identification of the RP2D. Each cohort will aim to further assess safety, pharmacokinetics (PK), pharmacodynamics (PD), and efficacy.

Group Type EXPERIMENTAL

Blinatumomab

Intervention Type DRUG

Blinatumomab will be administered as a subcutaneous (SC) injection.

Ph-IIC: Clinical PK Evaluation of SC Blinatumomab Formulations

1 cohort of adult participants will be enrolled into the Ph-IIC arm. The clinical PK evaluation cohort (Ph-IIC) will be conducted to compare the PK of SC1 and SC2 formulations at the preliminary RP2D determined from the dose expansion phase, in participants with R/R B-ALL.

Group Type EXPERIMENTAL

Blinatumomab

Intervention Type DRUG

Blinatumomab will be administered as a subcutaneous (SC) injection.

Ph-IIR: Efficacy of SC Blinatumomab in Participants with R/R B-ALL

The efficacy of SC blinatumomab (in the SC2 formulation) will be evaluated in adults and adolescents with R/R B-ALL.

Group Type EXPERIMENTAL

Blinatumomab

Intervention Type DRUG

Blinatumomab will be administered as a subcutaneous (SC) injection.

Ph-IIM: Efficacy of SC Blinatumomab in Participants with MRD+ B-ALL

The efficacy of SC blinatumomab (in the SC2 formulation) will be evaluated in adults and adolescents with MRD+ B-ALL.

Group Type EXPERIMENTAL

Blinatumomab

Intervention Type DRUG

Blinatumomab will be administered as a subcutaneous (SC) injection.

Interventions

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Blinatumomab

Blinatumomab will be administered as a subcutaneous (SC) injection.

Intervention Type DRUG

Other Intervention Names

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AMG 103

Eligibility Criteria

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Inclusion Criteria

* Ph-IIC, Dose Escalation and Dose Expansion: Aged 18 years or older (or same or greater than legal age within the country if it is older than 18 years).
* Ph-IIRa and Ph-IIMa: Aged ≥ 17 years at time of informed consent.
* Ph-IIRb and Ph-IIMb: Age ≥ 12 years and \< 17 years at time of informed consent.
* Ph-IIR, Ph-IIC, Dose escalation, Dose Expansion: Participants with R/R B-precursor ALL.
* Relapsed or Refractory B-precursor ALL at any time after first salvage therapy.
* Relapsed B-precursor ALL at any time after allogenic hematopoietic stem cell transplant (HSCT).
* Ph-IIR, Ph-IIC, Dose escalation, Dose expansion: Greater than or equal to 5% blasts in the Bone Marrow per local assessment.
* Ph-IIM: B-precursor ALL and bone marrow blasts (BMB) ≥ 0.01% and \< 5% per local assessment.
* Ph-IIM: Availability of an appropriate archival BM specimen from initial or relapse diagnosis and the screening BM sample.
* Participants aged ≥ 18 years: Eastern Cooperative Oncology Group (ECOG) Performance Status less than or equal to 2.
* Participants aged 16 to \< 18 years old: Karnofsky Performance Score ≥ 50%.
* Participants aged \< 16 years old: Lansky Performance Score ≥ 50%.
* Any Ph+ participant intolerant or refractory to prior tyrosine kinase inhibitors (TKIs) are eligible.
* Ph-IIM: BM function as follows:

* Absolute Neutrophil Count (ANC) ≥ 500/μL
* Platelet count ≥ 50 000/μL (transfusion permitted)
* Hemoglobin level ≥ 9 g/dL (transfusion permitted)

Exclusion Criteria

* Active ALL in the central nervous system (CNS). Presence of greater than 5 white blood cells per cubic millimeter in cerebrospinal fluid (CSF) with lymphoblasts present and/or clinical signs of CNS leukemia. If CSF leukemia is present subjects will have to receive intrathecal therapy and have documented negative CSF prior to enrolling.
* History or presence of clinically relevant CNS pathology (excluding headache) such as epilepsy, childhood or adult seizure, paresis, aphasia, stroke, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, psychosis or severe (≥ grade 3) CNS events including immune effector cell-associated neurotoxicity syndrome (ICANS) from prior chimeric antigen receptor T-cell (CAR T) or other T cell engager therapies.
* Isolated Extramedullary (EM) Disease.
* For Ph-IIM only: Current EM disease or presence of circulating leukemia blasts.
* Current autoimmune disease or history of autoimmune disease with potential CNS involvement.
* Active acute or chronic graft versus host disease requiring systemic treatment with immunosuppressive medication.
* Symptoms and/or signs that indicate an acute or uncontrolled chronic infection, any other disease or condition that could be exacerbated by the treatment or would complicate protocol compliance.
* Testicular leukemia.
* History of malignancy (with certain exceptions) other than ALL within 3 years prior to start of protocol-specified therapy.
* Allogeneic HSCT within 12 weeks before the start of protocol-specified therapy.
* Cancer chemotherapy within 2 weeks before the start of protocol-specified therapy (with certain exceptions).
* Immunotherapy within 4 weeks before start of protocol-specified therapy.
* Prior failed cluster of differentiation (CD19) directed therapy such as prior blinatumomab or CD19 CAR T cells will be allowed (with demonstrated continued CD19+ expression), if treatment ended more than 4 weeks prior to start of protocol therapy and no prior CNS complications.
* Currently receiving treatment in or less than 30 days or 5 half-lives since ending treatment on another investigational study(ies).
* Abnormal screening laboratory parameters.
* Female participant: Pregnant or breastfeeding or planning to become pregnant or donate eggs, or expected to breastfeed during treatment and for 96 hours after the last dose of investigational product (SC blinatumomab).
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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BeOne Medicines

INDUSTRY

Sponsor Role collaborator

Amgen

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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MD

Role: STUDY_DIRECTOR

Amgen

Locations

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Hopital Saint Antoine

Paris, , France

Site Status RECRUITING

City of Hope National Medical Center

Duarte, California, United States

Site Status RECRUITING

Johns Hopkins University

Baltimore, Maryland, United States

Site Status RECRUITING

New York University Grossman School of Medicine and New York University Langone Hospitals

New York, New York, United States

Site Status RECRUITING

University of Texas MD Anderson Cancer Center

Houston, Texas, United States

Site Status RECRUITING

Fred Hutchinson Cancer Center

Seattle, Washington, United States

Site Status RECRUITING

Fred Hutchinson Cancer Center

Seattle, Washington, United States

Site Status COMPLETED

Westmead Hospital

Westmead, New South Wales, Australia

Site Status RECRUITING

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status RECRUITING

Monash Medical Centre

Clayton, Victoria, Australia

Site Status RECRUITING

Austin Health, Austin Hospital

Heidelberg, Victoria, Australia

Site Status RECRUITING

The Alfred Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Universitaetsklinikum Allgemeines Krankenhaus Wien

Vienna, , Austria

Site Status COMPLETED

Arthur J E Child Comprehensive Cancer Centre

Calgary, Alberta, Canada

Site Status RECRUITING

University of Alberta

Edmonton, Alberta, Canada

Site Status RECRUITING

Vancouver General Hospital, Gordon and Leslie Diamond Health Care Centre

Vancouver, British Columbia, Canada

Site Status RECRUITING

Princess Margaret Cancer Centre

Toronto, Ontario, Canada

Site Status RECRUITING

Centre Hospitalier Regional Universitaire de Lille - Hopital Claude Huriez

Lille, , France

Site Status RECRUITING

Centre Hospitalier Universitaire de Nice - Hopital l Archet

Nice, , France

Site Status RECRUITING

Institut Universitaire du Cancer Toulouse Oncopole

Toulouse, , France

Site Status RECRUITING

Universitaetsklinikum Augsburg

Augsburg, , Germany

Site Status RECRUITING

Charite - Universitaetsmedizin Berlin, Campus Benjamin Franklin

Berlin, , Germany

Site Status RECRUITING

Universitaetsklinikum Koeln

Cologne, , Germany

Site Status RECRUITING

Universitaetsklinikum Jena

Jena, , Germany

Site Status RECRUITING

Universitaetsklinikum Leipzig

Leipzig, , Germany

Site Status RECRUITING

Universitaetsklinikum Tuebingen

Tübingen, , Germany

Site Status COMPLETED

Universitatsklinikum Ulm

Ulm, , Germany

Site Status RECRUITING

Azienda Socio Sanitaria Territoriale Papa Giovanni xxiii

Bergamo, , Italy

Site Status RECRUITING

IRCCS Azienda Ospedaliero Universitaria di Bologna Policlinico di Sant Orsola

Bologna, , Italy

Site Status RECRUITING

Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia

Brescia, , Italy

Site Status RECRUITING

IRCCS Ospedale San Raffaele

Milan, , Italy

Site Status COMPLETED

Azienda Ospedaliera Policlinico Umberto I

Roma, , Italy

Site Status RECRUITING

Akita University Hospital

Akita, Akita, Japan

Site Status RECRUITING

National Cancer Center Hospital East

Kashiwa-shi, Chiba, Japan

Site Status RECRUITING

Fukushima Medical University Hospital

Fukushima, Fukushima, Japan

Site Status RECRUITING

Yokohama City University Medical Center

Yokohama, Kanagawa, Japan

Site Status RECRUITING

Erasmus Medisch Centrum

Rotterdam, , Netherlands

Site Status RECRUITING

Chonnam National University Hwasun Hospital

Hwasun-gun, Jeollanam-do, , South Korea

Site Status RECRUITING

The Catholic University of Korea Seoul St Marys Hospital

Seoul, , South Korea

Site Status RECRUITING

Hospital Universitario Virgen del Rocio

Seville, Andalusia, Spain

Site Status COMPLETED

Complejo Asistencial Universitario de Salamanca Hospital Universitario de Salamanca

Salamanca, Castille and León, Spain

Site Status RECRUITING

Institut Catala d Oncologia Badalona Hospital Universitari Germans Trias i Pujol

Badalona, Catalonia, Spain

Site Status RECRUITING

Clinica Universidad de Navarra

Pamplona, Navarre, Spain

Site Status RECRUITING

Hospital Clinico Universitario de Valencia

Valencia, Valencia, Spain

Site Status RECRUITING

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status RECRUITING

Bagcilar Medipol Mega Universite Hastanesi

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Izmir Ekonomi Universitesi Medical Point Hastanesi

Izmir, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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United States Australia Austria Canada France Germany Italy Japan Netherlands South Korea Spain Turkey (Türkiye)

Central Contacts

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Amgen Call Center

Role: CONTACT

Phone: 866-572-6436

Email: [email protected]

References

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Jabbour E, Zugmaier G, Agrawal V, Martinez-Sanchez P, Rifon Roca JJ, Cassaday RD, Boll B, Rijneveld A, Abdul-Hay M, Huguet F, Cluzeau T, Diaz MT, Vucinic V, Gonzalez-Campos J, Rambaldi A, Schwartz S, Berthon C, Hernandez-Rivas JM, Gordon PR, Bruggemann M, Hamidi A, Chen Y, Wong HL, Panwar B, Katlinskaya Y, Markovic A, Kantarjian H. Single agent subcutaneous blinatumomab for advanced acute lymphoblastic leukemia. Am J Hematol. 2024 Apr;99(4):586-595. doi: 10.1002/ajh.27227. Epub 2024 Feb 5.

Reference Type BACKGROUND
PMID: 38317420 (View on PubMed)

Jabbour E, Lussana F, Martinez-Sanchez P, Torrent A, Rifon JJ, Agrawal V, Tormo M, Cassaday RD, Cluzeau T, Huguet F, Papayannidis C, Hernandez-Rivas JM, Rijneveld A, Fleming S, Vucinic V, Boll B, Ikezoe T, Abdul-Hay M, Savoie ML, Schuh AC, Berthon C, Schwartz S, Chiaretti S, Yuda J, Miyazaki T, Gonzalez-Campos J, Chen Y, Wong H, Choudhry J, Zugmaier G, Guest E, Gordon P, Kantarjian H. Subcutaneous blinatumomab in adults with relapsed or refractory B-cell acute lymphoblastic leukaemia: post-hoc safety and activity analysis from a multicentre, single-arm, phase 1/2 trial. Lancet Haematol. 2025 Jul;12(7):e529-e541. doi: 10.1016/S2352-3026(25)00144-9. Epub 2025 Jun 15.

Reference Type DERIVED
PMID: 40532723 (View on PubMed)

Related Links

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http://www.amgentrials.com

AmgenTrials clinical trials website

Other Identifiers

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2023-506136-32

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

20180257

Identifier Type: -

Identifier Source: org_study_id