Inotuzumab ozogamicin for the treatment of acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is an uncommon disorder that affects about 20% of adults with acute leukemia. Historically, those who relapse from this condition have a dismal prognosis. Recent developments in immunoconjugate usage has changed the landscape of lymphoid B-cell malignancy therapy. One recent development is the FDA approved therapy inotuzumab ozogamicin which has the potential to reduce the overall toxicity of intensive regimens for ALL, as well as to possibly increase the number of patients who may achieve a state of minimal residual disease. Areas covered: In this review, the pre-clinical and clinical experiences with inotuzumab ozogamicin in lymphoma and ALL are reviewed. The article further includes the published phase I, II and III studies in ALL and considers the safety and efficacy of this treatment. Expert opinion: Inotuzumab ozogamicin is likely to be used, primarily, as a potent agent for relapsed ALL, either as the first choice or for those who fail treatment with blinatumumab. Its potential in newly diagnosed patients is currently unknown, such that the overall impact is likely to be important, but limited.