Flotetuzumab as a salvage immunotherapy in advanced CD123-positive hematological malignancies, a phase 1 pilot study

Leuk Lymphoma. 2024 Aug;65(8):1127-1135. doi: 10.1080/10428194.2024.2343029. Epub 2024 Apr 17.

Abstract

CD123 "expression" is common in hematological malignancies, including acute lymphoblastic leukemia (ALL). Flotetuzumab is a novel, investigational CD3/CD123 DART®. We conducted a phase 1 study evaluating safety and efficacy of flotetuzumab in relapsed/refractory ALL (Cohort A) and other advanced CD123-positive hematological malignancies (excluding myeloid malignancies) (cohort B). Thirteen patients (9 in Cohort A and 4 in Cohort B) were treated at dose level 1 (500 ng/kg/day) before early closure due to discontinuation of drug development by sponsor. Two dose limiting toxicities (Grade 4 thrombocytopenia and neutropenia) occurred in one patient in Cohort B. Cytokine release syndrome occurred in most patients (85%), all being grade ≤2. Responses only occurred in Cohort B, with a partial response in one patient with Hodgkin's lymphoma and morphological complete remission in the bone marrow in one patient with blastic plasmacytoid dendritic cell neoplasm. In conclusion, flotetuzumab had a manageable safety profile in advanced CD123-positive hematological malignancies.

Keywords: ALL; CD123; Flotetuzumab; immunotherapy; lymphoma.

Publication types

  • Clinical Trial, Phase I

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antineoplastic Agents, Immunological / administration & dosage
  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use
  • Female
  • Hematologic Neoplasms* / diagnosis
  • Hematologic Neoplasms* / drug therapy
  • Hematologic Neoplasms* / pathology
  • Hematologic Neoplasms* / therapy
  • Humans
  • Immunotherapy / adverse effects
  • Immunotherapy / methods
  • Interleukin-3 Receptor alpha Subunit* / antagonists & inhibitors
  • Male
  • Middle Aged
  • Pilot Projects
  • Salvage Therapy* / methods
  • Treatment Outcome
  • Young Adult

Substances

  • Interleukin-3 Receptor alpha Subunit
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • IL3RA protein, human