Anti-CD20 treatment switch effective, more successful than desensitization
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Switching a B-cell lymphoma or leukemia treatment from CD20-directed immunotherapy to an alternative option may offer a successful alternative to desensitization protocols in instances of severe drug hypersensitivity.
“The switch to an alternative anti-CD20 is effective and safe. And probably, it’s also more successful than the desensitization protocols in managing severe hypersensitivity reactions to anti-CD20,” Paola Ghione, MD, of Memorial Sloan Kettering, said in the recorded presentation of their poster from ASCO20 Virtual Scientific Session.
Ghione explained Sloan Kettering had used some of these alternative protocols with anecdotal success, so they looked at the pharmacy database and analyzed the patients who underwent these protocols, comparing them to the traditional desensitization protocol.
“Desensitization protocols often require hospitalization or long infusion hours over a couple of days. And especially in this time where we want our patients to be out of the hospital as much as possible, it makes sense to find a less complicated alternative to continue administering these very important drugs,” Ghione said.
The database contained 47 patients who required interventions, 10 due to allergic reaction and eight due to serum sickness. Ghione reported that 55% of patients received the anti-CD20 agent in combination with chemotherapy while 34% received it as a single agent.
Twenty-six patients received desensitization, which failed in eight cases. Five of those failures switched to an alternative treatment. Twenty-one patients underwent a switch in their anti-CD20 treatment, which failed in three patients.
Though the rate of breakthrough with desensitization was 28.6% and the rate of breakthrough with switching was 11.1%, the trend did not reach significance, Ghione said.
“But certainly, there was an advantage in the group of those switched to anti-CD20,” she added. “Almost all the patients with one strategy or another could actually go on to receive their anti-CD20 treatment. But probably more patients that switched to an alternative anti-CD20 were OK long-term, even after failing the desensitization.”
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Ghione P, et al. Abstract 8062. Presented at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
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