TOWER
The first randomised proof that a T-cell engager beats chemotherapy: blinatumomab nearly doubled survival in relapsed adult ALL.
Median OS 7.7 vs 4.0 months (HR 0.71, 95% CI 0.55-0.93); CR within 12 weeks 34% vs 16%; 76% of blinatumomab responders were MRD-negative. NEJM 2017. Converted the 2014 accelerated approval to full approval.
Setting
Relapsed or refractory Ph-negative B-ALL, adults: blinatumomab vs standard salvage chemotherapy
Phase
Phase 3
Sponsor
Amgen
Registry
Headline result
OS 7.7 vs 4.0 months; HR 0.71.
Reported
2017
Enrolled
405
Replication
RIALTO (children) and BLAST (MRD-positive) reproduced high MRD-negative remission rates; E1910 and AALL1731 confirmed benefit frontline.
In plain words
What these results mean for people, not percentages
Overall survival (median)primarysurvival endpoint
- Median 7.7 vs 4 months with Blinatumomab compared with Chemotherapy; about 3.7 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 29 percent lower chance of the event at any given time (hazard ratio 0.71, likely range 0.55 to 0.93).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
Complete remission within 12 weekssurrogate endpoint
- 34 vs 16 out of 100 had no sign of cancer on scans or tests with Blinatumomab compared with Chemotherapy; 18 more per 100.
- Roughly one extra person helped for every 6 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
Be careful
- These results apply to the people the trial enrolled: Relapsed or refractory Ph-negative B-ALL, adults: blinatumomab vs standard salvage chemotherapy. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
405 participants enrolled.
Overall survival (median)primary
HR 0.71 (0.55–0.93) · p = 0.01
Blinatumomab
7.7 mo
Chemotherapy
4 mo
Complete remission within 12 weeks
Blinatumomab34 of 100
Chemotherapy16 of 100
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival (median)primary | Blinatumomab | 271 | 7.7 months | 0.71 (0.55–0.93) | 0.01 | link |
| Chemotherapy | 134 | 4 months | ||||
| Complete remission within 12 weeks | Blinatumomab | — | 34% | — | — | — |
| Chemotherapy | — | 16% |
Replication
RIALTO (children) and BLAST (MRD-positive) reproduced high MRD-negative remission rates; E1910 and AALL1731 confirmed benefit frontline.