1. COMPREHENSIVE CANCER CENTER OF NORTHWESTERN UNIVERSITY
ROBERT H. LURIE
COMPREHENSIVE CANCER CENTER
OF NORTHWESTERN UNIVERSITY

2. Pilot Trial of Campath ® (Alemtuzumab) in CTCL
C.Querfeld, T. Kuzel, J. Guitart, and S. Rosen

3. Campath ® (Alemtuzumab)
Humanized MAb that targets the CD52 antigen
Nonmodulating glycoprotein, function unknown
Expressed on:
Lymphocytes
Monocytes
Macrophages
Not expressed on:
Stem cells
Bone marrow progenitor cells
Causes lymphocyte lysis via:
ADCC
Complement fixation
Possible induction of apoptosis

4. Twenty-two previously treated patients Stage II - IV
Alemtuzumab in CTCL
Twenty-two previously treated patients
Stage II - IV
Alemtuzumab IV x 12 weeks
Prophylactic antibiotics
CR – 32%; PR – 23%
TTF-median 12m (5-32+)
CMV (18%); Serious infections (14%)
Neutropenia grade 4 (18%), Thrombocytopenia grade 4 (5%)
Lundin, J et al. Blood: 101, 2003

5. Kennedy, GA et al. Eur J Haematol: 71, 2003
Alemtuzumab in CTCL
Eight previously treated patients
Stage II - IV
Alemtuzumab IV; Median 6 weeks (2 – 13)
Prophylactic antibiotics
PR – 38%; TTF ≤ 4M
Anemia grade 4 (12%), neutropenia grade 4 (38%), and thrombocytopenia grade 4 (38%)
CMV (25%); Serious infections (25%)
Kennedy, GA et al. Eur J Haematol: 71, 2003

6. Alemtuzumab in patients with erythrodermic cutaneous T-cell lymphoma
RHLCCC Experience (2/01 – present)
30 mg IV t.i.w. for 4 weeks (first and second dose 3 mg and 10 mg)
30 mg SQ t.i.w. for 8 weeks
Prophylaxis with TMP-SMZ, acyclovir, fluconazole until immune reconstitution

7. Alemtuzumab in CTCL (SS) (RHLCCC Experience (n=19)
Age (years)
Median (range)
63 (39-88)
Gender
Male 9
Female 10
TNM stage
III
8 (42%)
IVA
10 (53%)
IVB
1 (5%)
No. prior treatments
5 (2-10)

8. Alemtuzumab in CTCL (SS) (RHLCCC Experience (n=19)
Follow-up (months)
Median (range)
18 (1-50)
Best response CR
9 (47%) PR
6 (32%) PD
4 (21%)
Response duration (months)
6 (1-37+)
Survival time (months)
Median
18 (1-50+)
Current status
Alive 9
Dead 10

9. Alemtuzumab in CTCL (SS) (RHLCCC Experience (n=19)
Hematologic toxicity during alemtuzumab
NCI Grade I II
III IV
Anemia 1 4
Leukopenia - 8
Thrombopenia

10. Toxicities related to Alemtuzumab (n = 19)
Symptoms
NCI Grade I/II
III/IV
Constitutional
Pruritus/pain
Fatigue
Rigor
Fever
Sweats/chills 10 2 5 1 3 8
Infection*
Skin 9
Neurology
Gastrointestinal
*PICC line infection, Herpes zoster, neck abscess

11. 75y ♂, stage III
Before treatment
12 weeks Campath

12. 56y ♂, stage IVB
Before Treatment
1 month post Campath

13. 78y ♂, stage III
Before Tx
6 weeks

14. 49y ♀, stage III
Before treatment
12 weeks alemtuzumab

16. Alemtuzumab (Campath®) Future Considerations
Dosage
Frequency
Maintenance
Combination Therapy

17. CHICAGO