TINI 2: Total Therapy for Infants With Acute Lymphoblastic Leukemia II
Summary
The purpose of this study is to improve upon the TINI study treatment. The study will test the ability of a type of immunotherapy called blinatumomab to clear persistent leukemia. Blinatumomab targets CD19 which is located on the leukemia cells outer membrane.
Arms & interventions
- DrugDexamethasone
Given orally (PO) or naso-gastrically (NG) or intravenously (IV).
- DrugMitoxantrone
Given IV
- DrugPEG asparaginase
Given IV
- DrugBortezomib
Given IV
- DrugVorinostat
Taken PO or NG
- DrugMercaptopurine
Given PO or NG.
- DrugMethotrexate
Given IV, IM or PO
- DrugBlinatumomab
Will be administered at 15 mcg/m2/day for 28 days following induction and reinduction
- DrugZiftomenib
3+3 dose escalation will be done. Dose level 1 will start at 75% of the adult recommended phase two dosing which has been established in phase I studies. Based on tolerability, we will either de-escalate to 50% RP2D (dose level -1) or escalate to 100% RP2D
Outcome measures
Primary
Minimal Residual Disease
Proportion of patients who are minimal residual disease positive at the end of Induction Intensification
Time frame: 5 years and 2 months
Secondary
Ziftomenib Minimum safe and Biologically-Effective Dose in Combination with Chemotherapy
Time frame: 5 years and 6 months
Event Free Survival
Time frame: 8 years
Overall Survival
Time frame: 8 years
Eligibility criteria
Study locations (17)
Phoenix Children's Hospital
Phoenix, Arizona, 85016
Arkansas Children's Hospital
Little Rock, Arkansas, 72202
Children's Hospital Los Angeles
Los Angeles, California, 90027
Valley Children's Hospital
Madera, California, 93636
Children's Hospital of Orange County
Orange, California, 92868
Stanford University
Palo Alto, California, 94304
Rady Children's Hospital San Diego
San Diego, California, 92123
Arnold Palmer Hospital for Children
Orlando, Florida, 32806
Children's Hospital of Minnesota
Minneapolis, Minnesota, 55404
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
Novant Health - Hemby Children's Hospital
Charlotte, North Carolina, 28204
Doernbecher Children's Hospital
Portland, Oregon, 97239
Penn State Milton S Hershey Medical Center
Hershey, Pennsylvania, 17033-0850
MD Anderson
Houston, Texas, 77030
University of Texas Health Science Center San Antonio
San Antonio, Texas, 78229
University of Utah Huntsman Cancer Institute
Salt Lake City, Utah, 84108
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507
References
- Davis KL, Yao CC, Zimmerman JAO, Rau RE. Immunotherapy in B-Cell Acute Lymphoblastic Leukemia. J Natl Compr Canc Netw. 2025 Dec;23(12):e257067. doi: 10.6004/jnccn.2025.7067.(PubMed)