Dr. Brammer on Data With Inotuzumab Ozogamicin in ALL

Jonathan E. Brammer, MD, assistant professor, internal medicine, The Ohio State University Comprehensive Cancer Center—James, discusses data that have been reported with inotuzumab ozogamicin (Besponsa) in acute lymphoblastic leukemia (ALL).

Inotuzumab ozogamicin is an antibody-drug conjugate that targets CD22, which is present on B-cell ALL cells.

The phase 3 INO-VATE study showed that 80% of patients who received inotuzumab ozogamicin achieved remissions compared with 30% of those who received standard chemotherapy. However, these remissions are generally short-lived, says Brammer. It is an effective agent, but it should be considered a bridge to transplant.

In terms of adverse effects, inotuzumab ozogamicin is associated with veno-occlusive disease. In the INO-VATE trial, 14% of patients had veno-occlusive disease. Therefore, chemotherapy agents that are known to induce veno-occlusive disease, such as busulfan, should be avoided when using this drug, says Brammer.

Although blinatumomab (Blincyto) could be used as an alternative agent to avoid the potential complication of busulfan, both drugs are recommended in National Comprehensive Cancer Network guidelines as bridges to transplant, concludes Brammer.