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Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/221187

Exploring Synergistic Approaches to Enhance Blinatumomab's Efficacy in Acute Lymphoblastic Leukemia

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Resistance to blinatumomab (CD19-CD3 BiTE) is a significant obstacle in the treatment of B-cell precursor acute lymphoblastic leukemia (BCP-ALL), prompting the investigation of novel drug combinations. We aimed to generate an "in vitro" model capable of identifying synergistic combinations to enhance blinatumomab's efficacy in BCP-ALL treatment. Drug response profiling used annexin V/propidium iodide/CD3 staining and flow cytometry analysis in 28 patient samples and 4 cell lines. Co-cultured with healthy donor T-cells, samples were treated for 24h with blinatumomab and/or other inhibitors. Differential sensitivity to blinatumomab was observed among patient samples and cell lines. Idelalisib (tyrosin kinase inhibitor; TKi) combined with blinatumomab exhibited potential antagonistic effects. Birinapant (SMAC mimetic) and venetoclax (BCL2 inhibitor) demonstrated increased efficacy in BCP-ALL cell lines, displaying synergistic potential with blinatumomab. Our findings support TKi and SMAC mimetics' immunomodulatory effects, in accordance to prior anti-CD19 CAR T cell reports. Venetoclax emerges as a promising candidate for combination therapy against blinatumomab resistance.

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LÁZARO, J., et al. Exploring Synergistic Approaches to Enhance Blinatumomab's Efficacy in Acute Lymphoblastic Leukemia. Klinische Pädiatrie. 2024. Vol. 236, num. 3. ISSN 0300-8630. [consulted: 16 of June of 2026]. Available at: https://hdl.handle.net/2445/221187

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