Common brand names

• Besponsa

How it is administered

Inotuzumab ozogamicin is given as an intravenous (IV) infusion. It is supplied as a sterile, lyophilized powder that must be reconstituted and diluted before administration. The medication is administered over one hour, and the dosing schedule is based on body surface area, typically given on Days 1, 8, and 15 of a 21- or 28-day cycle, depending on the patient’s response and treatment plan. Premedication with a corticosteroid, antipyretic, and antihistamine is recommended before each infusion to reduce the risk of infusion-related reactions.

How it works

Inotuzumab ozogamicin is a targeted therapy known as an antibody-drug conjugate. It works by combining a monoclonal antibody that specifically binds to the CD22 protein, which is found on the surface of certain cancer cells, with a cytotoxic (cell-killing) agent called calicheamicin. Once the antibody attaches to the CD22 protein on the cancer cell, the entire complex is taken into the cell. Inside, the cytotoxic agent is released, causing double-stranded breaks in the cell’s DNA. This leads to cell cycle arrest and ultimately causes the cancer cell to die through a process called apoptosis.

This targeted approach helps to deliver the cancer-killing drug directly to the cancer cells, potentially limiting damage to healthy cells. However, some healthy cells may still be affected, which can lead to side effects.

Who should take it

Inotuzumab ozogamicin is indicated for the treatment of relapsed or refractory CD22-positive B-cell precursor acute lymphoblastic leukemia (ALL) in adults and children aged 1 year and older. It is used when the leukemia has come back after previous treatments or has not responded to other therapies.

While inotuzumab ozogamicin is not specifically approved for follicular lymphoma, it targets CD22, a protein also found on some other B-cell malignancies. Its use in blood cancers is based on the expression of CD22 on the cancer cells, and your doctor will determine if this treatment is appropriate for your specific situation based on your diagnosis and previous treatments.

Who should not take it

There are no absolute contraindications listed for inotuzumab ozogamicin. However, patients with a history of severe liver problems, including hepatic veno-occlusive disease (VOD), or those with ongoing serious liver disease should use this medication with caution, as it can worsen liver function and increase the risk of VOD.

Women who are pregnant should not take inotuzumab ozogamicin, as it can cause harm to the developing fetus. Women of childbearing potential and men with partners of childbearing potential should use effective contraception during treatment and for several months after the last dose. It is also recommended not to breastfeed while receiving this medication and for 2 months after the last dose.

Commonly used with

Inotuzumab ozogamicin is often used as a single agent for relapsed or refractory CD22-positive B-cell precursor ALL. In some cases, it may be used as a bridge to hematopoietic stem cell transplant (HSCT) if the patient responds to therapy. It is not typically combined with other chemotherapy agents during the same cycle, but your healthcare team may use supportive medications such as corticosteroids, antipyretics, and antihistamines to help manage side effects.

Commonly tested with

In clinical trials, inotuzumab ozogamicin has been compared to standard chemotherapy regimens such as fludarabine, cytarabine, and granulocyte colony-stimulating factor (FLAG), mitoxantrone plus cytarabine, or high-dose cytarabine. It is also studied in combination with supportive care medications to manage side effects and as part of treatment plans leading up to stem cell transplantation.