NGS MRD-Guided Blinatumomab Treatment for Pediatric B-ALL

NCT ID: NCT06763302

Last Updated: 2025-01-08

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

1220 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-01

Study Completion Date

2030-12-31

Brief Summary

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The goal of this clinical trial is to determine whether pediatric B-cell acute lymphoblastic leukemia (B-ALL) patients with negative deep minimal residue disease (MRD) can benefit from blinatumomab treatment.

The main questions it aims to answer are:

1. Whether the application of blinatumomab can improve the long-term survival of next generation sequence (NGS) MRD-positive B-ALL children after consolidation therapy?
2. Whether the application of blinatumomab can benefit the NGS MRD-negative B-ALL children after consolidation therapy?

Detailed Description

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Conditions

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B Cell Precursor Acute Lymphoblastic Leukemia Pediatric Minimal Residual Disease Next Generation Sequencing (NGS)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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EOC NGS MRD positive Group

Based on the B-ALL treatment protocol, NGS MRD levels will be monitored at the end of consolidation treatment (EOC). If NGS MRD is positive (≥0.0001%), one course of blinatumomab (28 days) will be added after the consolidation treatment.

Group Type EXPERIMENTAL

Blinatumomab

Intervention Type DRUG

The FDA has approved blinatumomab for post-consolidation treatment in all Ph-negative B-ALL cases, regardless of MRD status. Considering the high cost of blinatumomab and the financial burden on families, we aim to precisely identify the population who would benefit from blinatumomab and provide appropriate treatment.

EOC NGS MRD negative Group A

Based on the B-ALL treatment protocol, NGS MRD levels will be monitored at the end of consolidation treatment (EOC). If NGS MRD is negative (\< 0.0001%), the IR/HR patients will be randomized into A and B two groups. EOC NGS MRD negative Group A will be added by one course of blinatumomab (28 days) treatment after the consolidation treatment.

Group Type ACTIVE_COMPARATOR

Blinatumomab

Intervention Type DRUG

The FDA has approved blinatumomab for post-consolidation treatment in all Ph-negative B-ALL cases, regardless of MRD status. Considering the high cost of blinatumomab and the financial burden on families, we aim to precisely identify the population who would benefit from blinatumomab and provide appropriate treatment.

EOC NGS MRD negative Group B

Based on the B-ALL treatment protocol, NGS MRD levels will be monitored at the end of consolidation treatment (EOC). If NGS MRD is negative (\< 0.0001%), the IR/HR patients will be randomized into A and B two groups. EOC NGS MRD negative Group B will continue the original chemotherapy treatment plan.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Blinatumomab

The FDA has approved blinatumomab for post-consolidation treatment in all Ph-negative B-ALL cases, regardless of MRD status. Considering the high cost of blinatumomab and the financial burden on families, we aim to precisely identify the population who would benefit from blinatumomab and provide appropriate treatment.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Clincial dianogsis of acute lymphoblastic leukemia (B-cell type) by morphology, immunology, cytogenetics, and molecular biology (MICM).
* Age ≥1 year and \<18 years.
* Informed consent signed, with the parents or guardians agreeing to a unified treatment protocol.

Exclusion Criteria

* Age \<1 year or ≥18 years.
* Immunophenotyping suggests mature B-cell leukemia, mixed-lineage leukemia, or T-cell acute lymphoblastic leukemia.
* Secondary leukemia or second tumor, CML blast phase ALL.
* Other tumors or immunodeficiency diseases present.
Minimum Eligible Age

1 Year

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Children's Hospital of Zhejiang University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Xiaojun Xu

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Xiaojun Xu

Role: CONTACT

+86-571-88873450

References

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Chen H, Gu M, Liang J, Song H, Zhang J, Xu W, Zhao F, Shen D, Shen H, Liao C, Tang Y, Xu X. Minimal residual disease detection by next-generation sequencing of different immunoglobulin gene rearrangements in pediatric B-ALL. Nat Commun. 2023 Nov 17;14(1):7468. doi: 10.1038/s41467-023-43171-9.

Reference Type BACKGROUND
PMID: 37978187 (View on PubMed)

Other Identifiers

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2024-IRB-0307-P-01

Identifier Type: -

Identifier Source: org_study_id

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