scholarly journals Alemtuzumab Induced Thyroid Disease in Multiple Sclerosis: A Review and Approach to Management

2015 ◽  
Vol 42 (5) ◽  
pp. 284-291 ◽  
Author(s):  
Moeber Mahzari ◽  
Amel Arnaout ◽  
Mark S. Freedman
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibody ◽  
Autoimmune Disease ◽  
Thyroid Gland ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Simple Approach ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

AbstractAlemtuzumab, an anti-CD52 monoclonal antibody, was recently approved for treatment of MS in Canada, having shown to significantly reduce relapses and disability in patients, particularly those who relapsed despite first line treatment. Offsetting its benefit however, is the development of novel secondary autoimmune disease, particularly affecting the thyroid gland in up to 36% of patients. The incidence of Alemtuzumab induced thyroid dysfunction (AITD) will likely rise as alemtuzumab becomes more widely used for treating MS. We review the clinical and investigational cues that help delineate the aetiology and management of thyrotoxicosis and hypothyroidism in ATID. AITD can be easily managed and we present a simple approach for its evaluation and management by neurologists that should be implemented prior to considering a referral to an internist or endocrinologist for further opinion or treatment.

First-line treatment with alemtuzumab for active multiple sclerosis: A nationwide post-marketing survey in Austria

2017 ◽  
Vol 381 ◽  
pp. 796
Author(s):  
F. Otto ◽  
B. Bajer-Kornek ◽  
P. Rommer ◽  
F. Leutmezer ◽  
C. Franta-Elmer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Line Treatment ◽  
First Line ◽  
Post Marketing ◽  
First Line Treatment ◽  
Active Multiple Sclerosis

Current Treatment Approaches to Newly Diagnosed Multiple Myeloma

2021 ◽  
Vol 44 (12) ◽  
pp. 690-699
Author(s):  
Susanne Ghandili ◽  
Katja C. Weisel ◽  
Carsten Bokemeyer ◽  
Lisa Beatrice Leypoldt
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Antibody ◽  
Plasma Cell ◽  
Cell Clone ◽  
Unmet Need ◽  
Continuous Treatment ◽  
High Dose ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

<b><i>Background:</i></b> Multiple myeloma is a so far incurable malignant plasma cell disorder. During the past 2 decades, treatment paradigms substantially changed when novel drugs were introduced initially in treatment of relapsed disease and subsequently also in first-line treatment. <b><i>Summary:</i></b> Up to now, first-line treatment differs between patients initially classified as transplant eligible and those who are considered as nontransplant eligible. Transplant-eligible patients receive a primary proteasome inhibitor (PI)-based induction which is being combined with an immunomodulating agent and a CD38-directed monoclonal antibody followed by high-dose melphalan therapy and autologous stem cell transplantation with subsequent maintenance treatment with lenalidomide. Patients who are considered as nontransplant eligible receive upfront treatment preferentially with a continuous combination treatment either with a CD38-directed monoclonal antibody in combination with the immunomodulating agent lenalidomide or a lenalidomide-PI combination followed by lenalidomide maintenance. <b><i>Key Messages:</i></b> Primary goal of the initiated treatment is to induce a rapid and deep remission which ideally leads to an eradication of the residual plasma cell clone in sense of a minimal residual disease negativity. Achievement of long-term remission with limited toxicity despite continuous treatment strategies and maintenance or improvement of life-quality is key. Despite successful treatment options, specific difficult-to-treat subgroups, especially patients with high-risk myeloma remain with inferior prognosis and a clear unmet need for novel therapeutic strategies. Future concepts will evaluate cellular treatments and other innovative immunotherapies in first-line treatment in curative intention.

scholarly journals P2.01-01 Cemiplimab, a Human PD-1 Monoclonal Antibody, Versus Chemotherapy in First-Line Treatment of Advanced NSCLC with PD-L1 ≥50%

2019 ◽  
Vol 14 (10) ◽  
pp. S638
Author(s):  
A. Sezer ◽  
M. Gogishvili ◽  
D. Bentsion ◽  
S. Kilickap ◽  
A. Lowczak ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Advanced Nsclc ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

Phase II trial of subcutaneous anti-CD52 monoclonal antibody alemtuzumab (Campath-1H) as first-line treatment for patients with B-cell chronic lymphocytic leukemia (B-CLL)

Blood ◽  
2002 ◽  
Vol 100 (3) ◽  
pp. 768-773 ◽  
Author(s):  
Jeanette Lundin ◽  
Eva Kimby ◽  
Magnus Björkholm ◽  
Per-Anders Broliden ◽  
Fredrik Celsing ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Bone Marrow ◽  
Chronic Lymphocytic Leukemia ◽  
B Cell ◽  
Lymphocytic Leukemia ◽  
Prolonged Treatment ◽  
Line Treatment ◽  
First Line ◽  
Cell Chronic Lymphocytic Leukemia ◽  
First Line Treatment

Abstract This phase II study determined the efficacy and safety of alemtuzumab, a humanized anti-CD52 monoclonal antibody, delivered subcutaneously as first-line therapy, over a prolonged treatment period of 18 weeks in 41 patients with symptomatic B-cell chronic lymphocytic leukemia (B-CLL). Injections were administered subcutaneously 3 times per week, from week 2 to 3 onward. An overall response rate (OR) of 87% (95% CI, 76%-98%; complete remission [CR], 19%; partial remission [PR], 68%) was achieved in 38 evaluable patients (81% of intent-to-treat population). CLL cells were cleared from blood in 95% patients in a median time of 21 days. CR or nodular PR in the bone marrow was achieved in 66% of the patients and most patients achieved this after 18 weeks of treatment. An 87% OR (29% CR) was achieved in the lymph nodes. The median time to treatment failure has not yet been reached (18+ months; range, 8-44+ months). Transient injection site skin reactions were seen in 90% of patients. Rigor, rash, nausea, dyspnea, and hypotension were rare or absent. Transient grade IV neutropenia developed in 21% of the patients. Infections were rare, but 10% patients developed cytomegalovirus (CMV) reactivation. These patients rapidly responded to intravenous ganciclovir. One patient, allergic to cotrimoxazole prophylaxis, developedPneumocystis carinii pneumonia. Alemtuzumab is highly effective as first-line treatment in patients with B-CLL. Prolonged treatment is important for maximal bone marrow response. Subcutaneous administration induced very few “first-dose” flulike symptoms and may reduce health care costs in comparison with the intravenous infusions.

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