Common brand names

• Besponsa

How it is administered

Inotuzumab ozogamicin is given as an intravenous (IV) infusion. It comes as a sterile, white to off-white powder that is reconstituted and diluted before being administered directly into a vein over the course of one hour. The dosing schedule is based on cycles, with specific doses given on Days 1, 8, and 15 of each cycle. The exact dose is calculated based on your body surface area (m²), and the cycle length can be 21 or 28 days depending on your response and recovery from side effects. Premedication with a corticosteroid, antipyretic, and antihistamine is recommended before each infusion to reduce the risk of infusion reactions.

How it works

Inotuzumab ozogamicin is a targeted therapy known as an antibody-drug conjugate. It is designed to specifically recognize and bind to a protein called CD22, which is found on the surface of certain cancerous B-cells, including those in lymphoblastic lymphoma and acute lymphoblastic leukemia (ALL). Once bound to the CD22 protein, the drug is taken into the cancer cell, where it releases a powerful cytotoxic agent called calicheamicin. This agent causes breaks in the DNA of the cancer cell, leading to cell cycle arrest and programmed cell death (apoptosis). By targeting CD22-positive cells, inotuzumab ozogamicin helps to minimize damage to normal, healthy cells and focuses its effects on the cancerous cells.

Who should take it

Inotuzumab ozogamicin is indicated for adults and children (1 year and older) with relapsed or refractory CD22-positive B-cell precursor acute lymphoblastic leukemia (ALL). While it is not specifically approved for lymphoblastic lymphoma, this medication may be considered in cases where the disease expresses CD22 and behaves similarly to ALL, especially if other treatments have not been successful.

Patients who have previously tried standard chemotherapy and whose disease has returned or not responded may benefit from this medication. It is also used as a bridge to stem cell transplant in some cases, helping to achieve remission before transplantation.

Who should not take it

There are no absolute contraindications listed for inotuzumab ozogamicin. However, patients with a history of severe liver disease, including veno-occlusive disease (VOD), or those who have experienced prior VOD, should use this medication with extreme caution, as it can increase the risk of worsening liver problems.

Patients who are pregnant or may become pregnant should not use inotuzumab ozogamicin, as it can cause harm to an unborn baby. Women should use effective contraception during treatment and for 8 months after the last dose, and men with partners of childbearing potential should use contraception for 5 months after the last dose. Breastfeeding is not recommended during treatment and for 2 months after the last dose.

Commonly used with

Inotuzumab ozogamicin is often used as a single agent in relapsed or refractory disease. In some cases, it may be used in combination with other chemotherapy agents or as a bridge to hematopoietic stem cell transplant (HSCT). Before starting, patients may receive medications to reduce the number of circulating cancer cells, such as hydroxyurea, steroids, or vincristine.

Commonly tested with

In clinical studies, 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 tested in combination with supportive care medications, including corticosteroids, antipyretics, and antihistamines to manage infusion reactions.