Overview
Despite advances in treatment for B-cell acute lymphoblastic leukemia (B-ALL), including newer options like blinatumomab and CAR-T cell therapy, many patients are not cured with initial therapies and need further treatment after their disease returns. This study used real-world data from the Flatiron Health Research Database to understand the unmet need in patients who experience a second relapse of B-ALL and require a third round of treatment (3L).
Among 388 patients who started treatment for B-ALL, half eventually needed 3L therapy. Most of these patients were adolescents and young adults (AYAs, ages 12–40) or adults up to age 64. The most common 3L treatment was multi-agent chemotherapy, followed by regimens containing blinatumomab and inotuzumab. Notably, only a small fraction (4%) received commercial CAR-T therapy, and over a quarter of those treated with blinatumomab in 3L had already received it in earlier lines of therapy.
Why this matters
Using high-quality real-world data, this research highlights a significant gap in effective treatment options for people with B-ALL who relapse after two prior therapies. By identifying these real-world treatment patterns and unmet needs, this study underscores the urgent need for new, more effective therapies for patients facing relapsed or refractory B-ALL, especially for adolescents, young adults, and middle-aged adults who make up the majority of those requiring 3L treatment.