Results of inotuzumab ozogamicin, a CD22 monoclonal antibody, in refractory and relapsed acute lymphocytic leukemia. Issue 15 (30th April 2013)

• Record Type: Journal Article
• Authors: Kantarjian, Hagop; Thomas, Deborah; Jorgensen, Jeffrey; Kebriaei, Partow; Jabbour, Elias; Rytting, Michael; York, Sergernne; Ravandi, Farhad; Garris, Rebecca; Kwari, Monica; Faderl, Stefan; Cortes, Jorge; Champlin, Richard; O'Brien, Susan
• Is Part Of: Cancer. Volume 119:Issue 15(2013)
• Page Start: 2728
• Page End: 2736
• Publication Date: 2013-04-30
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28136
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr28136-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>CD22 expression occurs in >90% of patients with acute lymphocytic leukemia (ALL). Inotuzumab ozogamicin, a CD22 monoclonal antibody bound to calicheamicin, is active in ALL.</p> </sec> <sec id="cncr28136-sec-0002" sec-type="section"> <title>METHODS</title> <p>Patients with refractory‐relapsed ALL received treatment with inotuzumab. The first 49 patients received single‐dose, intravenous inotuzumab at doses of 1.3 to 1.8 mg/m2 every 3 to 4 weeks. In the next 41 patients, the schedule was modified to inotuzumab weekly at a dose of 0.8 mg/m2 on day 1 and at a dose of 0.5 mg/m2 on days 8 and 15, every 3 to 4 weeks, based on higher in vitro efficacy with more frequent exposure.</p> </sec> <sec id="cncr28136-sec-0003" sec-type="section"> <title>RESULTS</title> <p>Ninety patients were treated; 68% were in salvage 2 or beyond. Overall, 17 patients (19%) achieved a complete response (CR), 27 (30%) had a CR with no platelet recovery (CRp), and 8 (9%) had a bone marrow CR (no recovery of counts), for an overall response rate of 58%. Response rates were similar for single‐dose and weekly dose inotuzumab (57% vs 59%, respectively). The median survival was 6.2 months overall, 5.0 months with the single‐dose schedule, and 7.3 months with the weekly dose schedule. The median survival was 9.2 months for patients in salvage 1 (37% at 1 year), 4.3 months for patients in salvage 2, and 6.6 months for patients in salvage 3 or later. The median remission duration was 7 months. Reversible bilirubin elevation, fever, and hypotension were observed less frequently on the weekly dose. In total, 36 of 90 patients (40%) underwent allogeneic stem cell transplantation. Veno‐occlusive disease was noted in 6 of 36 patients after stem cell transplantation (17%), was less frequent after the weekly schedule (7%), and with less alkylators in the preparative regimen.</p> </sec> <sec id="cncr28136-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Inotuzumab single‐agent therapy was highly active, safe, and convenient in patients with refractory‐relapsed ALL. A weekly dose schedule appeared to be equally effective and less toxic than a single‐dose schedule. <bold><italic>Cancer</italic> 2013</bold>;119:2728–2736. © <italic>2013 American Cancer Society</italic>.</p> </sec> </abstract>