Inotuzumab ozogamicin treatment for patients with acute lymphoblastic leukemia and the burden of hospitalization

This study aimed to investigate if treatment with inotuzumab ozogamicin in patients with relapsed/unresponsive acute lymphoblastic leukemia was associated with lower healthcare system burden compared to standard of care.  

This study concluded that inotuzumab ozogamicin treatment in these patients was associated with a lower hospitalization burden compared to standard of care.  

In a phase 3 trial (INO-VATE), inotuzumab ozogamicin (Besponsa;– INO) has shown improvement in different outcomes for patients with relapsed or refractory (unresponsive) acute lymphoblastic leukemia (RR-ALL). There were improved overall survival (OS), a high rate of complete remission (all signs of cancer gone; CR), and a manageable safety profile compared to standard of care (SOC; intensive chemotherapy).  

However, during treatment, many patients develop complication from the disease or the treatment and often need hospitalization. It was unknown if treatment with INO could be associated with a lower healthcare system burden compared to SOC. 

This study involved 307 patients who had been involved in the INO-VATE trial. Patients had received treatment of INO once a week (164) or SOC (143). The days hospitalized per month during study treatment were calculated.   

82.9% of INO-treated patients experienced at least one hospitalization compared to 94.4% for SOC-treated patients. The average hospitalization days per patient month was 7.6 for the INO group compared to 18.4 days for the SOC group. This means the INO group patients spent 25% of their treatment time in hospital compared to 60.5% of treatment time in hospital for the SOC group. 

The main reasons for hospitalization were RR-ALL treatment (5.2 days for INO group compared to 14 days for the SOC group), treatment side effects (1.4 days for the INO group compared to 2.8 days for the SOC group) or other reasons (1 day for the INO group compared to 1.6 days for the SOC group). 

This study concluded that INO treatment in RR-ALL was associated with a lower hospitalization burden compared with SOC. The authors suggested that this lower burden has a favorable impact on healthcare budgets and cost-effectiveness considerations. 

This study included patients from a phase 3 clinical trial that were recruited according to specific characteristics. They may no represent the everyday clinical practice. Further studies are needed.