Gemtuzumab ozogamicin for the treatment of acute myeloid leukemia in adults

Expert Opin Biol Ther. 2021 Jul;21(7):849-862. doi: 10.1080/14712598.2021.1825678. Epub 2020 Oct 5.

Abstract

Introduction: Treatment of acute myeloid leukemia (AML) has changed dramatically in the past ten years with the approval of targeted agents, the first of which was the anti-CD33 antibody-drug conjugate gemtuzumab ozogamicin (GO). Despite withdrawal from the market after accelerated approval, GO was reapproved and now has a well-established role in treating select AML patients. CD33 has proven to be an important target for drug development in AML as evidenced by the improvement in survival with GO treatment.

Areas covered: The review summarizes the development of GO, its mechanism of action, initial studies and approval, withdrawal from the market, and subsequent reapproval after the results of several large randomized studies became available. We also provide an overview of its current role in the treatment landscape of AML.

Expert opinion: Multiple phase 3 trials with GO have established a significant benefit with GO in induction therapy for favorable risk AML. Additional studies support the use of GO in relapsed/refractory AML and APL. Despite the withdrawal of GO from the market after initial approval, GO has proven to improve survival of select AML patients when added to induction chemotherapy and in relapsed disease.

Keywords: Gemtuzumab ozogamicin; acute myeloid leukemia; acute promyelocytic leukemia; allogeneic hematopoietic stem cell transplant; venous occlusive disease.

MeSH terms

  • Adult
  • Aminoglycosides / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols
  • Gemtuzumab
  • Humans
  • Leukemia, Myeloid, Acute* / drug therapy

Substances

  • Aminoglycosides
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Gemtuzumab