II. Indications
-
Hairy Cell Leukemia
- Moxetumomab pasudotox-tdfk
-
B Cell precursor Acute Lymphoblastic Leukemia
- Inotuzumab Ozogamicin
III. Mechanism
IV. Medications
- Moxetumomab pasudotox-tdfk (Lumoxiti)
- Conjugated Monoclonal Antibody that delivers the cytotoxic drug Pseudomonas exotoxin A to cancer cells
- Avoid in severe Renal Insufficiency (eGFR <30 ml/min)
- Used in Hairy Cell Leukemia
- Risks of Hemolytic Uremic Syndrome, capillary leak syndrome, Nephrotoxicity, Electrolyte abnormalities
- Inotuzumab Ozogamicin (Besponsa)
- Conjugated Monoclonal Antibody that delivers the cytotoxic drug calicheamicin to cancer cells
- Used against B Cell precursors in Acute Lymphoblastic Leukemia
- Risks of hepatotoxicity and hepatic veno-occlusive disease
V. Dosing
- See other references for disease specific dosing protocols
VI. Adverse Effects: Moxetumomab
- Hemolytic Uremic Syndrome
- Capillary leak syndrome
- Nephrotoxicity
- Obtain Renal Function testing before each dose
- Infusion Reaction
- Premedicate
-
Electrolyte abnormalities
- Obtain Electrolytes before each dose and at 8 days after dose
- Other common adverse effects
VII. Adverse Effects: Inotuzumab
- Infusion Reactions
- QTc Prolongation
- Hepatotoxicity
- Includes hepatic veno-occlusive disease (sinusoidal obstruction)
- Increased transaminases, GGT, and Serum Bilirubin
- Myelosuppression
- Other common adverse effects
VIII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters, Unknown Pregnancy category)
- Use reliable Contraception
- Monitoring
- Renal Function tests
- Serum Electrolytes (including Serum Calcium, Serum Phosphorus)
- Liver Function Tests (LFTs)
IX. Resources
- Moxetumomab pasudotox-tdfk (DailyMed)
- Inotuzumab Ozogamicin (DailyMed)