Profile of inotuzumab ozogamicin and its potential in the treatment of acute lymphoblastic leukemia

Figures & data

Figure 1 Structure of inotuzumab ozogamicin.

Notes: Inotuzumab ozogamicin is an antibody-drug conjugate that consists of a humanized monoclonal antibody inotuzumab linked to a cytotoxic agent from the class of calicheamicins.

Figure 2 Mechanisms of action of inotuzumab ozogamicin.

Notes: The antibody–antigen complex is rapidly internalized (because of its subnanomolar binding affinity) upon binding to CD22. Then, calicheamicin is released inside the leukemic cell, where it binds to the minor DNA groove, inducing double stranded DNA breaks. DNA breaks are followed by apoptosis of the malignant cell.
Abbreviation: DNA, deoxyribonucleic acid.

Table 1 Characteristics and outcomes of relapsed/refractory acute lymphoblastic leukemia patients treated with inotuzumab ozogamicin used as a single agent

Characteristics	Single dose schedule 49 patients	Weekly schedule 41 patients	Overall 90 patients
ECOG PS
0–1	44 (90%)*	37 (90%)	81 (90%)
≥2	5 (10%)	4 (10%)	9 (10%)
Salvage status
First salvage	13 (27%)	16 (39%)	29 (32%)
Second salvage	24 (49%)	10 (24%)	34 (38%)
Further salvage	12 (24%)	15 (37%)	27 (30%)
Karyotype
Diploid	12 (24%)	9 (22%)	21 (23%)
T(9;22)	7 (14%)	8 (20%)	15 (17%)
T(4;11)	5 (10%)	3 (7%)	8 (9%)
Other	25 (51%)	21 (51%)	46 (51%)
CD22 positivity
>90%	28 (57%)	31 (76%)	59 (66%)
70%–89%	14 (29%)	8 (20%)	22 (24%)
50%–69%	7 (14%)	2 (5%)	9 (10%)
Response to therapy
CR	9 (18%)	8 (20%)	17 (19%)
CRp	14 (29%)	13 (32%)	27 (30%)
CRi	5 (10%)	3 (7%)	8 (9%)
PR	0	0	0
Resistant	19 (39%)	15 (37%)	34 (38%)
Death within 4 weeks	2 (4%)	2 (5%)	4 (4%)

Notes:

* n (%). Adapted with permission from John Wiley & Sons, Inc. Kantarjian H, Thomas D, Jorgensen J, et al. Results of inotuzumab ozogamicin, a CD22 monoclonal antibody, in refractory and relapsed acute lymphocytic leukemia. Cancer. 2013;119: 2728–2736. © 2013 American Cancer Society.³⁴

Abbreviations: CR, complete response; CRi, bone marrow complete response with incomplete recovery; CRp, bone marrow complete response with incomplete recovery of platelets; ECOG PS, Eastern Cooperative Oncology Group performance status; PR, partial response.

Kantarjian H, Thomas D, Jorgensen J, et al. Results of inotuzumab ozogamicin, a CD22 monoclonal antibody, in refractory and relapsed acute lymphocytic leukemia. Cancer. 2013;119:2728–2736.

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