SC Blinatumomab Could Simplify MPAL Care, Expand Community Access

An ongoing phase 2 trial (NCT07222579) has seen early success with a new subcutaneous formulation of blinatumomab (Blincyto) in a patient with CD19-positive mixed phenotype acute leukemia (MPAL), a rare form of acute leukemia.

The first patient dosed in the trial, a 77-year-old woman with Philadelphia chromosome-positive, B/myeloid MPAL, has achieved complete remission with full hematologic recovery after only a single cycle of the agent, with favorable tolerability.¹ While the study still requires mature data to confirm these signals, the findings provide encouraging preliminary evidence supporting further investigation of this approach.

Importantly, the quick, convenient, subcutaneous administration could improve feasibility in community practice.

“Right now, there are very, very few community oncology practices that [can] handle the continuous infusion,” said Ashkan Emadi, MD, PhD, who is spearheading the trial. “This subcutaneous [formulation] will open the door for them [so] that they can serve their patients with MPAL.”

In an interview with Targeted Oncology, Emadi, of West Virginia University, discusses what this new subcutaneous formulation may mean for community clinics, and how it could potentially expand access to MPAL treatment beyond large cancer centers.

The transition from continuous infusion to a subcutaneous formulation for treating MPAL represents a transformative shift for community oncology clinics, where reduced chair time and ease of delivery are critical. The primary advantage of this new delivery method is the drastic reduction in chair time, which becomes virtually nonexistent; the only remaining limiting factor is the time required for the pharmacy to prepare the medication. This efficiency is critical for community settings where resources and staffing are often limited.

Currently, blinatumomab is administered via continuous intravenous (IV) infusion, a process fraught with logistical and technical challenges. These include the frequent malfunction of infusion pumps and the necessity of coordinating with specialized infusion companies. Most community oncology practices, especially those not attached to a major hospital, are not equipped to handle these complexities, according to Emadi. They often lack the overnight staff required to manage equipment issues. By removing these technical hurdles, the subcutaneous formulation effectively ends what Emadi describes as the"monopoly" that large tertiary cancer centers have traditionally held over MPAL treatment.

The simplicity of the subcutaneous regimenallows patients to receive an "under-the-skin" injection and return home immediately, with no weekend schedule required. This model is particularly vital for rural and "rugged" regions like West Virginia, where patients may live far from major hospitals and regional sites lack the staff for constant monitoring. Because oncologists are already familiar with delivering subcutaneous drugs, adopting this formulation for MPAL is a natural progression, Emadi says. Ultimately, this innovation opens the door for community practices to provide essential care locally, overcoming the significant burdens associated with traditional IV and continuous infusion protocols.

REFERENCE

1. WVU Cancer Institute first in the world to treat ultra-rare leukemia using novel subcutaneous immunotherapy. News release. West Virginia University Medicine. February 17, 2026. Accessed February 18, 2026. https://tinyurl.com/3fe4mbjf