Blinatumomab (Blincyto)

Canada’s Drug Agency (CDA-AMC) recommends that Blincyto be reimbursed by public drug plans for the treatment of patients with Philadelphia chromosome (Ph)–negative, CD19-positive B-cell precursor acute lymphoblastic leukemia (ALL) in the consolidation phase of multiphase chemotherapy if certain conditions are met. Blincyto should only be covered to treat adult and pediatric patients whose Ph-negative, CD19-positive B-cell ALL is in remission, regardless of whether patients still have detectable traces of cancer (minimal residual disease [MRD]). Remission is a response to treatment in which signs of cancer have disappeared, but it does not always mean the cancer is cured. Remission encompasses complete remission (CR) or CR with incomplete peripheral blood count recovery (CRi), which means the disease is in CR, but blood cell levels have not yet fully returned to normal. Blincyto should be initiated in the front-line consolidation phase of multiphase chemotherapy (treatment phase to improve remission). Blincyto should only be reimbursed if it is prescribed by clinicians with expertise in managing ALL in specialized cancer centres and if the cost of Blincyto is reduced.