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Clinical utility and patient considerations in the use of ofatumumab in chronic
lymphocytic leukemia
#MMPMID26425075
Frustaci AM
; Tedeschi A
; Picardi P
; Cairoli R
; Montillo M
Biologics
2015[]; 9
(?): 75-86
PMID26425075
show ga
Treatment aim for chronic lymphocytic leukemia has been radically changed over
the past years from providing only a palliative approach to reaching disease
eradication and improving survival. Ofatumumab is a monoclonal humanized antibody
with peculiar in vitro and in vivo properties, at present approved for double
fludarabine and alemtuzumab refractory chronic lymphocytic leukemia. Its efficacy
in this subset of patients, who typically have an unfavorable prognosis,
facilitated its use in different Phase II and III trials. Ofatumumab as single
agent or combined with chemotherapeutic or biologic agents, led to sundry results
in the setting of both previously treated or untreated patients. Its role in
maintenance therapy is also under investigation. Further advances concerning
ofatumumab administration as first line therapy in combination with chlorambucil,
came recently from the COMPLEMENT 1 study. Results from this trial will open the
door to new perspectives of its use in treatment-naïve patients. Ofatumumab was
well tolerated in almost all the studies, with the main adverse events relating
mostly to infusion reaction. Hematologic toxicity, especially neutropenia, was
also common. A significant improvement in patients' quality of life was reported
following ofatumumab treatment and this was mainly due to its effect on
constitutional symptoms. Nevertheless, some concerns remain regarding the
long-term efficacy of the drug in terms of response duration and survival. The
real strength of this drug needs to be confirmed by further studies and direct
comparative trials.