At 3.5 Years, 83% of Patients on BLINCYTO Plus
Chemotherapy Were Alive Versus 65% of Patients on Chemotherapy
Alone
Trial Design and Conduct Sponsored by the
ECOG-ACRIN Cancer Research Group
THOUSAND
OAKS, Calif., Dec. 13,
2022 /PRNewswire/ -- Amgen (NASDAQ: AMGN) today
announced the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) will
present results from the E1910 randomized Phase 3 trial. This is
the first study to demonstrate superior overall survival (OS) with
BLINCYTO added to consolidation chemotherapy over current standard
of care (multiagent consolidation chemotherapy) in newly diagnosed
adult patients with Philadelphia
chromosome-negative B-ALL who were measurable residual disease
(MRD)-negative following induction and intensification
chemotherapy. These results were featured in a press briefing on
Monday, Dec. 12 at 8:30 a.m. CT and presented on Tuesday, Dec. 13 at 9 a.m.
CT as a late breaking oral presentation (LBA1) at the
64th American Society of Hematology (ASH) Annual Meeting
& Exposition in New
Orleans.
Experience the full interactive Multichannel News Release
here: https://www.multivu.com/players/English/8812856-amgen-blincyto-blinatumomab-added-to-consolidation-chemotherapy-significantly-improves-survival/
"Treatment with BLINCYTO in addition to consolidation
chemotherapy reduced the risk of death by 58% compared to
chemotherapy alone. We are pleased by this remarkable improvement
in overall survival, and we look forward to sharing these data with
regulatory authorities as soon as possible," said David M. Reese, M.D., executive vice president
of Research and Development at Amgen. "Amgen continues to advance a
robust development program for BLINCYTO, with a focus on
minimizing chemotherapy and a subcutaneous formulation to help
address remaining unmet needs for patients with B-ALL."
The Phase 3 randomized trial (E1910), activated in December 2013, evaluated the safety and efficacy
of BLINCYTO added to standard of care consolidation chemotherapy
compared to chemotherapy alone in patients with newly diagnosed
B-ALL with no MRD after induction and intensification
chemotherapy. The primary endpoint was OS and key secondary
endpoints included relapse-free survival, MRD status, and incidence
of adverse events. Based on a recommendation by the ECOG-ACRIN Data
Safety Monitoring Committee and consistent with the pre-defined
efficacy threshold, results from the planned interim analysis are
now reported due to overwhelming efficacy reported in the BLINCYTO
arm.
With a median follow up of 43 months, the study met its primary
endpoint with a significant improvement in overall survival
favoring the BLINCYTO arm; median OS was not reached vs. 71.4
months in the control arm (hazard ratio [HR] = 0.42, 95% CI: 0.24 -
0.75; two-sided p=0.003). After about 3.5 years of follow-up, 83%
of the patients who went on to receive additional standard
consolidation chemotherapy plus experimental BLINCYTO were alive
versus 65% of those who received chemotherapy only. No new safety
signals were reported for the combination.
"Adults with newly diagnosed ALL can achieve a high rate of
complete remission with chemotherapy, but frequently relapse and
have disappointing survival rates.1,2 Historically,
outcomes for newly diagnosed adults with ALL have been
significantly worse than for children, where up to 90% of patients
are cured with frontline therapy.3,4 In this study,
survival rates for adults when blinatumomab was added to
chemotherapy are significantly improved in patients with
MRD-negative remission, approaching those we have seen in
children," said Selina M. Luger,
M.D., professor of hematology-oncology at the University of Pennsylvania's Abramson Cancer Center
and Perelman School of Medicine, chair of the ECOG-ACRIN Leukemia
Committee and an investigator on the study. "Moreover, the data
provide additional clinical evidence supporting the recent
guideline updates for adult ALL recommending blinatumomab as
consolidation in both MRD-positive and MRD-negative patients."
Data from the trial will be submitted to global regulatory
authorities, including where BLINCYTO has been previously
approved.
Study E1910 was designed and conducted independently from
industry with public funding. The ECOG-ACRIN Cancer Research Group
sponsored the trial with funding from the National Cancer Institute
(NCI), part of the National Institutes of Health. Other NCI-funded
network groups took part in the study. In addition, Amgen provided
BLINCYTO and support through an NCI Cooperative Research and
Development Agreement (CRADA).
E1910 Study Design
In the E1910 Phase 3
randomized trial, 488 patients aged 30-70 with newly diagnosed
B-ALL were enrolled. All participants initially received 2.5 months
of combination induction chemotherapy (step 1). After remission
induction (step 1), if patients were in complete remission, they
continued on-study and received an intensification course of high
dose chemotherapy (step 2). Subsequently, their remission and MRD
status were determined. All patients were then randomized/assigned
to receive four cycles of consolidation chemotherapy with or
without four 28-day cycles of BLINCYTO (step 3). Following FDA
approval of blinatumomab for MRD-positive patients in March 2018, MRD-positive participants were
assigned to the blinatumomab arm. MRD-negative patients continued
to be randomized. After completion of consolidation chemo +/-
BLINCYTO, patients were given 2.5 years of chemotherapy maintenance
therapy timed from the start of the intensification cycle (step
4).
For more information, please visit ClinicalTrials.gov.
About BLINCYTO® (blinatumomab)
BLINCYTO is a
BiTE® (bispecific T-cell engager) immuno-oncology therapy that
targets CD19 surface antigens on B cells. BiTE molecules fight
cancer by helping the body's immune system detect and target
malignant cells by engaging T cells (a type of white blood cell
capable of killing other cells perceived as threats) to cancer
cells. By bringing T cells near cancer cells, the T cells can
inject toxins and trigger cancer cell death (apoptosis). BiTE
immuno-oncology therapies are currently being investigated for
their potential to treat a wide variety of cancers.
BLINCYTO was granted breakthrough therapy and priority review
designations by the U.S. Food and Drug
Administration and is approved in the U.S. for the
treatment of:
- relapsed or refractory CD-19 positive B-cell precursor ALL in
adults and children.
- CD-19 positive B-cell precursor ALL in first or second complete
remission with minimal residual disease (MRD) greater than or equal
to 0.1% in adults and children. This indication is approved under
accelerated approval based on MRD response rate and hematological
relapse-free survival. Continued approval for this indication may
be contingent upon verification and description of clinical benefit
in the confirmatory trials.
In the European Union (EU), BLINCYTO is indicated as
monotherapy for the treatment of:
- adults with Philadelphia chromosome negative CD19
positive relapsed or refractory B-precursor acute lymphoblastic
leukemia (ALL).
- adults with Philadelphia chromosome negative CD19
positive B-precursor ALL in first or second complete remission with
minimal residual disease (MRD) greater than or equal to 0.1%.
- pediatric patients aged 1 year or older with
Philadelphia chromosome negative CD19 positive B-precursor ALL
which is refractory or in relapse after receiving at least two
prior therapies or in relapse after receiving prior allogeneic
hematopoietic stem cell transplantation
IMPORTANT SAFETY INFORMATION
WARNING: CYTOKINE RELEASE SYNDROME and NEUROLOGICAL
TOXICITIES
- Cytokine Release Syndrome (CRS), which may be
life-threatening or fatal, occurred in patients receiving
BLINCYTO®. Interrupt or discontinue
BLINCYTO® and treat with corticosteroids as
recommended.
- Neurological toxicities, which may be severe,
life-threatening or fatal, occurred in patients receiving
BLINCYTO®. Interrupt or discontinue
BLINCYTO® as recommended.
Contraindications
BLINCYTO® is contraindicated in patients with a
known hypersensitivity to blinatumomab or to any component of the
product formulation.
Warnings and Precautions
- Cytokine Release Syndrome (CRS): CRS, which may be
life-threatening or fatal, occurred in 15% of patients with R/R ALL
and in 7% of patients with MRD-positive ALL. The median time to
onset of CRS is 2 days after the start of infusion and the median
time to resolution of CRS was 5 days among cases that resolved.
Closely monitor and advise patients to contact their healthcare
professional for signs and symptoms of serious adverse events such
as fever, headache, nausea, asthenia, hypotension, increased
alanine aminotransferase (ALT), increased aspartate
aminotransferase (AST), increased total bilirubin (TBILI), and
disseminated intravascular coagulation (DIC). The manifestations of
CRS after treatment with BLINCYTO® overlap with
those of infusion reactions, capillary leak syndrome, and
hemophagocytic histiocytosis/macrophage activation syndrome. If
severe CRS occurs, interrupt BLINCYTO® until CRS
resolves. Discontinue BLINCYTO® permanently if
life-threatening CRS occurs. Administer corticosteroids for severe
or life-threatening CRS.
- Neurological Toxicities: Approximately 65% of patients
receiving BLINCYTO® in clinical trials experienced
neurological toxicities. The median time to the first event was
within the first 2 weeks of BLINCYTO® treatment and
the majority of events resolved. The most common (≥ 10%)
manifestations of neurological toxicity were headache and tremor.
Severe, life–threatening, or fatal neurological toxicities occurred
in approximately 13% of patients, including encephalopathy,
convulsions, speech disorders, disturbances in consciousness,
confusion and disorientation, and coordination and balance
disorders. Manifestations of neurological toxicity included cranial
nerve disorders. Monitor patients for signs or symptoms and
interrupt or discontinue BLINCYTO® as outlined in
the PI.
- Infections: Approximately 25% of patients receiving
BLINCYTO® in clinical trials experienced serious
infections such as sepsis, pneumonia, bacteremia, opportunistic
infections, and catheter-site infections, some of which were
life-threatening or fatal. Administer prophylactic antibiotics and
employ surveillance testing as appropriate during treatment.
Monitor patients for signs or symptoms of infection and treat
appropriately, including interruption or discontinuation of
BLINCYTO® as needed.
- Tumor Lysis Syndrome (TLS), which may be life-threatening or
fatal, has been observed. Preventive measures, including
pretreatment nontoxic cytoreduction and on-treatment hydration,
should be used during BLINCYTO® treatment. Monitor
patients for signs and symptoms of TLS and interrupt or discontinue
BLINCYTO® as needed to manage these events.
- Neutropenia and Febrile Neutropenia, including life-threatening
cases, have been observed. Monitor appropriate laboratory
parameters (including, but not limited to, white blood cell count
and absolute neutrophil count) during
BLINCYTO® infusion and interrupt
BLINCYTO® if prolonged neutropenia occurs.
- Effects on Ability to Drive and Use Machines: Due to the
possibility of neurological events, including seizures, patients
receiving BLINCYTO® are at risk for loss of
consciousness, and should be advised against driving and engaging
in hazardous occupations or activities such as operating heavy or
potentially dangerous machinery while BLINCYTO® is
being administered.
- Elevated Liver Enzymes: Transient elevations in liver enzymes
have been associated with BLINCYTO® treatment with
a median time to onset of 3 days. In patients receiving
BLINCYTO®, although the majority of these events were
observed in the setting of CRS, some cases of elevated liver
enzymes were observed outside the setting of CRS, with a median
time to onset of 19 days. Grade 3 or greater elevations in liver
enzymes occurred in approximately 7% of patients outside the
setting of CRS and resulted in treatment discontinuation in less
than 1% of patients. Monitor ALT, AST, gamma-glutamyl transferase,
and TBILI prior to the start of and during
BLINCYTO® treatment.
BLINCYTO® treatment should be interrupted if
transaminases rise to > 5 times the upper limit of normal (ULN)
or if TBILI rises to > 3 times ULN.
- Pancreatitis: Fatal pancreatitis has been reported in patients
receiving BLINCYTO® in combination with
dexamethasone in clinical trials and the post-marketing setting.
Evaluate patients who develop signs and symptoms of pancreatitis
and interrupt or discontinue BLINCYTO® and
dexamethasone as needed.
- Leukoencephalopathy: Although the clinical significance is
unknown, cranial magnetic resonance imaging (MRI) changes showing
leukoencephalopathy have been observed in patients receiving
BLINCYTO®, especially in patients previously treated
with cranial irradiation and antileukemic chemotherapy.
- Preparation and administration errors have occurred with
BLINCYTO® treatment. Follow instructions for
preparation (including admixing) and administration in the PI
strictly to minimize medication errors (including underdose and
overdose).
- Immunization: Vaccination with live virus vaccines is not
recommended for at least 2 weeks prior to the start of
BLINCYTO® treatment, during treatment, and until
immune recovery following last cycle of BLINCYTO®.
- Risk of Serious Adverse Reactions in Pediatric Patients due to
Benzyl Alcohol Preservative: Serious and fatal adverse reactions
including "gasping syndrome," which is characterized by central
nervous system depression, metabolic acidosis, and gasping
respirations, can occur in neonates and infants treated with benzyl
alcohol-preserved drugs including BLINCYTO® (with
preservative). When prescribing BLINCYTO® (with
preservative) for pediatric patients, consider the combined daily
metabolic load of benzyl alcohol from all sources including
BLINCYTO® (with preservative) and other drugs
containing benzyl alcohol. The minimum amount of benzyl alcohol at
which serious adverse reactions may occur is not known. Due to the
addition of bacteriostatic saline, 7-day bags of
BLINCYTO® solution for infusion with preservative
contain benzyl alcohol and are not recommended for use in any
patients weighing < 22 kg.
Adverse Reactions
- The most common adverse reactions (≥ 20%) in clinical trial
experience of patients with MRD-positive B-cell precursor ALL
(BLAST Study) treated with BLINCYTO® were pyrexia
(91%), infusion-related reactions (77%), headache (39%), infections
(pathogen unspecified 39%), tremor (31%), and chills (28%). Serious
adverse reactions were reported in 61% of patients. The most common
serious adverse reactions (≥ 2%) included pyrexia, tremor,
encephalopathy, aphasia, lymphopenia, neutropenia, overdose, device
related infection, seizure, and staphylococcal infection.
- The most common adverse reactions (≥ 20%) in clinical trial
experience of patients
with Philadelphia chromosome-negative relapsed or
refractory B-cell precursor ALL (TOWER Study) treated with
BLINCYTO® were infections (bacterial and pathogen
unspecified), pyrexia, headache, infusion-related reactions,
anemia, febrile neutropenia, thrombocytopenia, and neutropenia.
Serious adverse reactions were reported in 62% of patients. The
most common serious adverse reactions (≥ 2%) included febrile
neutropenia, pyrexia, sepsis, pneumonia, overdose, septic shock,
CRS, bacterial sepsis, device related infection, and
bacteremia.
- Adverse reactions that were observed more frequently (≥ 10%) in
the pediatric population compared to the adults with relapsed or
refractory B-cell precursor ALL were pyrexia (80% vs. 61%),
hypertension (26% vs. 8%), anemia (41% vs. 24%), infusion-related
reaction (49% vs. 34%), thrombocytopenia (34% vs. 21%), leukopenia
(24% vs. 11%), and weight increased (17% vs. 6%).
- In pediatric patients less than 2 years old (infants), the
incidence of neurologic toxicities was not significantly different
than for the other age groups, but its manifestations were
different; the only event terms reported were agitation, headache,
insomnia, somnolence, and irritability. Infants also had an
increased incidence of hypokalemia (50%) compared to other
pediatric age cohorts (15-20%) or adults (17%).
Dosage and Administration Guidelines
- BLINCYTO® is administered as a continuous
intravenous infusion at a constant flow rate using an infusion pump
which should be programmable, lockable, non-elastomeric, and have
an alarm.
- It is very important that the instructions for preparation
(including admixing) and administration provided in the full
Prescribing Information are strictly followed to minimize
medication errors (including underdose and overdose).
Please see full Prescribing Information and medication guide for
BLINCYTO at www.BLINCYTO.com.
About BiTE®
Technology
BiTE® (bispecific T cell engager)
technology is a targeted immuno-oncology platform that is designed
to engage patient's own T cells to any tumor-specific antigen,
activating the cytotoxic potential of T cells to eliminate
detectable cancer. The BiTE immuno-oncology platform has the
potential to treat different tumor types through tumor-specific
antigens. The BiTE platform has a goal of leading to off-the-shelf
solutions, which have the potential to make innovative T cell
treatment available to all providers when their patients need
it. Amgen is advancing more than a dozen BiTE molecules
across a broad range of hematologic malignancies and solid tumors,
further investigating BiTE technology with the goal of enhancing
patient experience and therapeutic potential. To learn more about
BiTE technology, visit www.AmgenBiTETechnology.com.
About Amgen Oncology
At Amgen Oncology, our
mission to serve patients drives all that we do. That's why we're
relentlessly focused on accelerating the delivery of medicines that
have the potential to empower all angles of care and transform
lives of people with cancer.
For the last four decades, we have been dedicated to discovering
the firsts that matter in oncology and to finding ways to reduce
the burden of cancer. Building on our heritage, Amgen continues to
advance the largest pipeline in the Company's history, moving with
great speed to advance those innovations for the patients who need
them.
For more information, follow us
on www.twitter.com/amgenoncology.
About Amgen
Amgen is committed to unlocking
the potential of biology for patients suffering from serious
illnesses by discovering, developing, manufacturing and delivering
innovative human therapeutics. This approach begins by using tools
like advanced human genetics to unravel the complexities of disease
and understand the fundamentals of human biology.
Amgen focuses on areas of high unmet medical need and
leverages its expertise to strive for solutions that improve health
outcomes and dramatically improve people's lives. A biotechnology
pioneer since 1980, Amgen has grown to be one
of the world's leading independent biotechnology
companies, has reached millions of patients around the world and is
developing a pipeline of medicines with breakaway potential.
Amgen is one of the 30 companies that comprise the Dow
Jones Industrial Average and is also part of the Nasdaq-100 index.
In 2022, Amgen was named one of the "World's Best Employers" by
Forbes and one of "America's 100 Most Sustainable Companies" by
Barron's.
For more information, visit Amgen.com and follow us
on Twitter, LinkedIn, Instagram, TikTok and YouTube.
Forward-Looking Statements
This news release contains
forward-looking statements that are based on the current
expectations and beliefs of Amgen. All statements, other than
statements of historical fact, are statements that could be deemed
forward-looking statements, including any statements on the
outcome, benefits and synergies of collaborations, or potential
collaborations, with any other company (including BeiGene, Ltd.,
Kyowa-Kirin Co., Ltd., or any collaboration to manufacture
therapeutic antibodies against COVID-19), the performance of
Otezla® (apremilast) (including anticipated Otezla sales growth and
the timing of non-GAAP EPS accretion), the Five Prime Therapeutics,
Inc. acquisition, the Teneobio, Inc. acquisition, the ChemoCentryx,
Inc. acquisition, or the proposed acquisition of Horizon
Therapeutics plc, as well as estimates of revenues, operating
margins, capital expenditures, cash, other financial metrics,
expected legal, arbitration, political, regulatory or clinical
results or practices, customer and prescriber patterns or
practices, reimbursement activities and outcomes, effects of
pandemics or other widespread health problems such as the ongoing
COVID-19 pandemic on our business, and other such estimates and
results. Forward-looking statements involve significant risks and
uncertainties, including those discussed below and more fully
described in the Securities and Exchange Commission reports filed
by Amgen, including our most recent annual report on Form 10-K and
any subsequent periodic reports on Form 10-Q and current reports on
Form 8-K. Unless otherwise noted, Amgen is providing this
information as of the date of this news release and does not
undertake any obligation to update any forward-looking statements
contained in this document as a result of new information, future
events or otherwise.
No forward-looking statement can be guaranteed and actual
results may differ materially from those we project. Discovery or
identification of new product candidates or development of new
indications for existing products cannot be guaranteed and movement
from concept to product is uncertain; consequently, there can be no
guarantee that any particular product candidate or development of a
new indication for an existing product will be successful and
become a commercial product. Further, preclinical results do not
guarantee safe and effective performance of product candidates in
humans. The complexity of the human body cannot be perfectly, or
sometimes, even adequately modeled by computer or cell culture
systems or animal models. The length of time that it takes for us
to complete clinical trials and obtain regulatory approval for
product marketing has in the past varied and we expect similar
variability in the future. Even when clinical trials are
successful, regulatory authorities may question the sufficiency for
approval of the trial endpoints we have selected. We develop
product candidates internally and through licensing collaborations,
partnerships and joint ventures. Product candidates that are
derived from relationships may be subject to disputes between the
parties or may prove to be not as effective or as safe as we may
have believed at the time of entering into such relationship. Also,
we or others could identify safety, side effects or manufacturing
problems with our products, including our devices, after they are
on the market.
Our results may be affected by our ability to successfully
market both new and existing products domestically and
internationally, clinical and regulatory developments involving
current and future products, sales growth of recently launched
products, competition from other products including biosimilars,
difficulties or delays in manufacturing our products and global
economic conditions. In addition, sales of our products are
affected by pricing pressure, political and public scrutiny and
reimbursement policies imposed by third-party payers, including
governments, private insurance plans and managed care providers and
may be affected by regulatory, clinical and guideline developments
and domestic and international trends toward managed care and
healthcare cost containment. Furthermore, our research, testing,
pricing, marketing and other operations are subject to extensive
regulation by domestic and foreign government regulatory
authorities. Our business may be impacted by government
investigations, litigation and product liability claims. In
addition, our business may be impacted by the adoption of new tax
legislation or exposure to additional tax liabilities. If we fail
to meet the compliance obligations in the corporate integrity
agreement between us and the U.S. government, we could
become subject to significant sanctions. Further, while we
routinely obtain patents for our products and technology, the
protection offered by our patents and patent applications may be
challenged, invalidated or circumvented by our competitors, or we
may fail to prevail in present and future intellectual property
litigation. We perform a substantial amount of our commercial
manufacturing activities at a few key facilities, including
in Puerto Rico, and also depend on third parties for a portion
of our manufacturing activities, and limits on supply may constrain
sales of certain of our current products and product candidate
development. An outbreak of disease or similar public health
threat, such as COVID-19, and the public and governmental effort to
mitigate against the spread of such disease, could have a
significant adverse effect on the supply of materials for our
manufacturing activities, the distribution of our products, the
commercialization of our product candidates, and our clinical trial
operations, and any such events may have a material adverse effect
on our product development, product sales, business and results of
operations. We rely on collaborations with third parties for the
development of some of our product candidates and for the
commercialization and sales of some of our commercial products. In
addition, we compete with other companies with respect to many of
our marketed products as well as for the discovery and development
of new products. Further, some raw materials, medical devices and
component parts for our products are supplied by sole third-party
suppliers. Certain of our distributors, customers and payers have
substantial purchasing leverage in their dealings with us. The
discovery of significant problems with a product similar to one of
our products that implicate an entire class of products could have
a material adverse effect on sales of the affected products and on
our business and results of operations. Our efforts to collaborate
with or acquire other companies, products or technology, and to
integrate the operations of companies or to support the products or
technology we have acquired, may not be successful. A breakdown,
cyberattack or information security breach could compromise the
confidentiality, integrity and availability of our systems and our
data. Our stock price is volatile and may be affected by a number
of events. Our business and operations may be negatively affected
by the failure, or perceived failure, of achieving our
environmental, social and governance objectives. The effects of
global climate change and related natural disasters could
negatively affect our business and operations. Global economic
conditions may magnify certain risks that affect our business. Our
business performance could affect or limit the ability of our Board
of Directors to declare a dividend or our ability to pay a dividend
or repurchase our common stock. We may not be able to access the
capital and credit markets on terms that are favorable to us, or at
all.
The scientific information discussed in this news release
related to our product candidates is preliminary and investigative.
Such product candidates are not approved by the U.S. Food and
Drug Administration, and no conclusions can or should be drawn
regarding the safety or effectiveness of the product candidates.
Further, any scientific information discussed in this news release
relating to new indications for our products is preliminary and
investigative and is not part of the labeling approved by
the U.S. Food and Drug Administration for the products.
The products are not approved for the investigational use(s)
discussed in this news release, and no conclusions can or should be
drawn regarding the safety or effectiveness of the products for
these uses.
CONTACT: Amgen, Thousand
Oaks
Megan Fox, 805-447-1423 (media)
Jessica Akopyan, 805-440-5721
(media)
Arvind Sood, 805-447-1060
(investors)
1 Maffini E., et al. Clin Hematol Int. 2019;
1(2):85-93.
2 Jabbour E., et al. Cancer. 2015; 121:2517-2528.
3 Leukemia & Lymphoma Society. Acute Lymphoblastic
Leukemia (ALL). Available at:
https://www.lls.org/research/acute-lymphoblastic-leukemia-all.
Accessed on November 29, 2022.
4 National Cancer Institute. Childhood Acute
Lymphoblastic Leukemia Treatment (PDQ®)–Health Professional
Version. Available at:
https://www.cancer.gov/types/leukemia/hp/child-all-treatment-pdq#:~:text=%5B74%2D78%5D-,Overall%20Prognosis,patients%20alive%20at%205%20years.
Accessed on November 29,
2022.
View original
content:https://www.prnewswire.com/news-releases/blincyto-blinatumomab-added-to-consolidation-chemotherapy-significantly-improves-survival-in-adult-patients-with-measurable-residual-disease-negative-b-lineage-acute-lymphoblastic-leukemia-b-all-301702114.html
SOURCE Amgen