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    Association details:
    Biomarker:BCR-ABL1 fusion
    Cancer:Acute Lymphocytic Leukemia
    Drug:Besponsa (inotuzumab ozogamicin) (DNA replication inhibitor, CD22-targeted antibody-drug conjugate)
    Direction:Sensitive
    Evidence:
    Evidence Level:
    Sensitive: A2 - Guideline
    New
    Source:
    NCCN
    Excerpt:
    Acute Lymphoblastic Leukemia: The following regimen was added with appropriate: Inotuzumab ozogamicin + mini-hyperCVD for B-ALL (cyclophosphamide, dexamethasone, vincristine, methotrexate, cytarabine)
    Evidence Level:
    Sensitive: C1 - Off-label
      (Approved for B Acute Lymphoblastic Leukemia)
    New
    Excerpt:
    Besponsa is indicated as monotherapy...Adult patients with Philadelphia chromosome positive (Ph+) relapsed or refractory B cell precursor ALL should have failed treatment with at least 1 tyrosine kinase inhibitor (TKI).
    Evidence Level:
    Sensitive: C4 – Case Studies
    Source:
    SOHO 2023
    Title:

    Inotuzumab Ozogamicin in the Treatment of Relapsed/Refractory (R/R) Ph‑Positive Acute Lymphoid Leukemia (ALL) With Extramedullary Disease: Our Experience

    Published date:
    09/01/2023
    Excerpt:
    "We present 2 cases of relapsed Ph-positive B-ALL with non-CNS extramedullary disease treated with IO….She refused a second HSCT and continued maintenance with ponatinib. Four months after the initial HSCT, she relapsed with extramedullary involvement of the breast and uterus. She was treated with one course of methotrexate and cytarabine-based chemotherapy, with progressive disease. Therefore, she received 6 cycles of IO with complete metabolic response....These 2 cases underscore the potential benefits of IO in Ph-positive advanced B-ALL with extramedullary involvement in comparison with classical chemotherapy.