Researchers from Germany have reported that, because of “efficacy, convenience, improved adverse effect profile and cost savings”, Campath® (alemtuzumab) given subcutaneously should be the treatment of choice for Fludara® (fludarabine)-refractory patients with chronic lymphocytic leukemia (CLL). The details of this study appeared early online in the Journal of Clinical Oncology on August 20, 2009.[1]
Campath is a fully human monoclonal antibody that selectively targets the CD52 antigen, which is expressed more prominently on malignant lymphocytes than other cells. The binding of Campath stimulates cellular lysis of the malignant lymphocytes and reduction or elimination of cancerous cells throughout the bone marrow, blood, and lymph system. Campath, however, is not targeted against hematopoietic stem cells. Campath is approved by the U.S. Food and Drug Administration for initial and subsequent treatment of patients with CLL. The approved mode of administration is intravenous with premedication with initial slow infusion. Several European studies have suggested that subcutaneous administration of Campath is safe and effective.
The current study enrolled 109 patients with Fludara-refractory CLL. One-hundred-three patients received Campath 30 mg three times per week for up to 12 weeks. The complete response rate was 4%, and the partial response rate was 30%. Median progression-free survival was 7.7 months, and median overall survival was 19 months. Campath response appeared to be independent of adverse risk factors such as 17p deletion, mutated TP53, and unmutated VH.
Comments: The use of SQ Campath should simplify the treatment of CLL. The package insert for Campath currently only lists the IV route.
Reference:
[1] Stilgenbauer S, Zenz T, Winkler D, et al. Subcutaneous alemtuzumab in fludarabine-frefractory chronic lymphocytic leukemia: clinical results and prognostic marker analyses from CKK2H study of the German Chronic Lymphocytic Leukemia Study Group. Journal of Clinical Oncology [early online publication]. August 20, 2009.
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