Inotuzumab ozogamicin in adult acute lymphoblastic leukemia: Development, current status, and future directions

Cancer. 2024 Nov 1;130(21):3631-3646. doi: 10.1002/cncr.35505. Epub 2024 Aug 2.

Abstract

Inotuzumab ozogamicin (InO) is an antibody-drug conjugate approved for the treatment of relapsed/refractory B-cell acute lymphoblastic leukemia (ALL). Several clinical trials are investigating InO in combination with low-intensity chemotherapy or other anti-ALL-targeted therapies in the salvage and frontline settings, notably in older adults who often cannot tolerate intensive chemotherapy and tend to have higher-risk disease. InO is also increasingly used to bridge patients to hematopoietic stem cell transplantation (HSCT), in sequence with chimeric antigen receptor T-cell therapy, to eliminate measurable residual disease and to prevent post-HSCT relapse. Veno-occlusive disease/sinusoidal obstruction syndrome is a potential complication of InO treatment, particularly when followed by HSCT. Herein, the authors review the historical development and current status of InO, strategies for mitigating the risk of InO-related veno-occlusive disease/sinusoidal obstruction syndrome, and future directions for InO research and clinical use.

Keywords: acute lymphoblastic leukemia; adult; inotuzumab ozogamicin; salvage therapy; sinusoidal obstruction syndrome; targeted therapy; veno‐occlusive disease.

Publication types

  • Review

MeSH terms

  • Adult
  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hepatic Veno-Occlusive Disease / chemically induced
  • Humans
  • Inotuzumab Ozogamicin*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy

Substances

  • Inotuzumab Ozogamicin
  • Antineoplastic Agents, Immunological

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