Time to First Subsequent Salvage Therapy in Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia Treated With Inotuzumab Ozogamicin in the Phase III INO-VATE Trial

We retrospectively analyzed INO-VATE trial data. We found patients with relapsed/refractory acute lymphoblastic leukemia who received inotuzumab ozogamicin (n = 164) were less likely to receive additional treatment after the study, and tended to live longer before needing additional treatment, than patients who received chemotherapy (n = 162). Inotuzumab ozogamicin may therefore enable patients to delay or avoid additional treatments and associated adverse impacts. Background: In relapsed/refractory acute lymphoblastic leukemia (R/R ALL), successive salvage therapies may worsen outcomes and decrease quality of life. This post hoc analysis of the phase III INO-VATE trial investigates subsequent salvage therapies and compared the time from randomization to first subsequent salvage therapy (TST) in the inotuzumab ozogamicin (InO) and standard-of-care chemotherapy (SoC) arms. Patients and Methods: Adults (aged =18 years) with CD22+ R/R ALL were randomized to InO (n = 164) or SoC (n = 162) treatment. We determined TST and proportion of patients receiving subsequent salvage therapies by treatment arm and for subgroups based on transplantation status and baseline characteristics. Results: In the InO versus SoC arm, a smaller proportion of patients received subsequent salvage therapy (34.1% [n = 56] vs. 56.8% [n = 92]), and TST was longer (median 19 vs. 4 months, hazard ratio 0.339, P <.0001). Similar benefits were seen with InO versus SoC irrespective of transplantation status, age, salvage phase, first remission duration, Philadelphia chromosome status, or CD22 expression. Following receipt of subsequent salvage therapy, median overall survival was 4 months, irrespective of treatment arm. Conclusion: Patients in the InO versus SoC arm were less likely to receive subsequent salvage therapy, and showed a clinically meaningful extension of TST irrespective of subgroup. This suggests InO treatment leads to improved outcomes by increasing the likelihood that subsequent salvage therapies and their associated adverse impacts can be delayed or avoided. (C) 2022 The Authors. Published by Elsevier Inc.

Automated summary

Retrospective analysis found that patients with relapsed/refractory acute lymphoblastic leukemia who received inotuzumab ozogamicin were less likely to receive additional treatment and had an extended period before needing additional treatment compared to patients who received chemotherapy.