# TOWER

Source: https://onco.cc/trials/tower/  
OnCo record `tower` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The first randomised proof that a T-cell engager beats chemotherapy: blinatumomab nearly doubled survival in relapsed adult ALL.

## Summary

TOWER, trial NCT02013167 sponsored by Amgen and published in the New England Journal of Medicine in 2017, was the first randomised proof that a T-cell engager beats chemotherapy: blinatumomab nearly doubled survival in relapsed or refractory Philadelphia-negative B-cell acute lymphoblastic leukaemia in adults. It randomised 405 patients to blinatumomab or standard salvage chemotherapy, met its primary overall survival endpoint, doubled the complete remission rate within twelve weeks, and most blinatumomab responders became MRD-negative, converting the 2014 accelerated approval to full approval. OnCo links it to acute lymphoblastic leukaemia, T-cell engagers, CD19 and CD3 as targets and blinatumomab. Whether blinatumomab can replace chemotherapy blocks altogether is the open question.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-07
- Registry id: NCT02013167
- Phase: 3
- Setting: Relapsed or refractory Ph-negative B-ALL, adults: blinatumomab vs standard salvage chemotherapy
- Sponsor: Amgen
- Enrolled: 405
- Result: OS 7.7 vs 4.0 months; HR 0.71.
- Outcomes: Overall survival (median): Blinatumomab 7.7 months vs Chemotherapy 4 months, HR 0.71; Complete remission within 12 weeks: Blinatumomab 34% vs Chemotherapy 16%
- Replication: RIALTO (children) and BLAST (MRD-positive) reproduced high MRD-negative remission rates; E1910 and AALL1731 confirmed benefit frontline.

## Sources

- ClinicalTrials.gov NCT02013167: https://clinicaltrials.gov/study/NCT02013167

## Connected records

- cancers: [Acute lymphoblastic leukaemia](https://onco.cc/cancers/all-leukemia/)
- technologies: [T-cell engagers (bispecific)](https://onco.cc/technologies/t-cell-engager/)
- targets: [CD19](https://onco.cc/targets/cd19/), [CD3](https://onco.cc/targets/cd3/)
- drugs: [Blinatumomab](https://onco.cc/drugs/blinatumomab/)
- companies: [Amgen](https://onco.cc/companies/amgen/)
- key papers: [Blinatumomab versus Chemotherapy for Advanced Acute Lymphoblastic Leukemia](https://onco.cc/key-papers/paper-blinatumomab-all-leukemia-n-engl-j-med-2017/)
- roadmaps: [Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first](https://onco.cc/roadmaps/paediatric-oncology-roadmap/)

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