On 16 June 2020, the US Food and Drug Administration (FDA) extended the indication of gemtuzumab ozogamicin (MYLOTARG, Wyeth Pharmaceuticals LLC) for newly diagnosed CD33-positive acute myeloid leukaemia (AML) to include paediatric patients 1 month and older.
Efficacy and safety in the paediatric population were supported by data from AAML0531 (NCT00372593), a multicentre randomised study of 1,063 patients with newly diagnosed AML ages 0 to 29 years. Patients were randomised to 5-cycle chemotherapy alone or with gemtuzumab ozogamicin (3 mg/m2) administered once on day 6 in Induction 1 and once on day 7 in Intensification 2.
The main efficacy outcome measure was event-free survival (EFS) measured from the date of trial entry until induction failure, relapse, or death by any cause. The EFS hazard ratio was 0.84 (95% confidence interval [CI] 0.71-0.99). The estimated percentage of patients free of induction failure, relapse, or death at five years was 48% (95% CI 43%-52%) in the gemtuzumab ozogamicin plus chemotherapy arm versus 40% (95% CI 36%‑45%) in the chemotherapy alone arm. No difference between treatment arms in overall survival was demonstrated.
The most common grade 3 and higher adverse reactions that occurred during Induction 1 and Intensification 2 in ≥ 5% of patients who received gemtuzumab ozogamicin were infection, febrile neutropenia, decreased appetite, hyperglycaemia, mucositis, hypoxia, haemorrhage, increased transaminase, diarrhoea, nausea, and hypotension.
Full prescribing information for MYLOTARG is available here.
This application was granted priority review.
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