Using Shared Experience to Define Optimal Care for Patients Receiving Blinatumomab on COG Clinical Trials (C228)

10:30 am – 11:30 am Saturday, September 17
Targeted therapies that leverage and harness the immune system to treat malignancies have become one of the most rapidly growing treatment approaches in pediatric oncology. Blinatumomab, an immunotherapy, is one such approach which has generated significant momentum in the treatment of pediatric B-lineage acute lymphoblastic leukemia (B-ALL) (1). In the relapsed space Blinatumomab has demonstrated improved survival and decreased rates of significant toxicity, compared to standard chemotherapy.
This ensures blinatumomab will be an immunotherapy incorporated into standard of care therapies, but also increasingly tested in clinical trials (2, 3, 4). Blinatumomab is complex to administer requiring continuous IV infusion over 28 days per cycle with the first 2-3 days recommended as inpatient administration, and the remainder of cycle administered in the outpatient setting (4). The burden of care predominantly falls to the family after discharge. Nursing plays a key role in transitioning families home by securing equipment, coordinating care, and most importantly, providing education to caregivers to safely care for their child during blinatumomab administration. With COG experience on trial AALL1331, and expansion of Blinatumomab to upfront therapy on AALL1731, an opportunity to gain the collective experience of administering and caring for pediatric patients receiving blinatumomab was presented. Understanding these experiences can assist with improving outcomes for patients receiving blinatumomab as it can shape future recommendations for clinical care and the development/provision of educational resources. To understand institutions’ experiences, we surveyed 213 COG sites to identify both successes and ongoing barriers to provision of optimal care of pediatric patients receiving blinatumomab. During this COG track session, we will share the survey results, highlight the evidence to support developed recommendations, and discuss future COG directions to improve the care and experience of pediatric patients receiving blinatumomab.