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mogamulizumab-kpkc
Anti-CCR4 Monoclonal Antibody Kyowa Kirin FDA Approved 2018
Indications Dosing Forms Contraindications Warnings Adverse Reactions Pharmacology Clinical Studies Tumor Types
1. Indications and Usage

Relapsed or refractory mycosis fungoides (MF) or SΓ©zary syndrome (SS) in adults who have received at least one prior systemic therapy.

2. Dosage and Administration

1 mg/kg IV over at least 60 minutes
Cycle 1: Days 1, 8, 15, 22 of 28-day cycle
Cycle 2+: Days 1 and 15 of each 28-day cycle
Continue until disease progression or unacceptable toxicity

3. Dosage Forms and Strengths

Injection: 20 mg/5 mL (4 mg/mL) single-dose vial

4. Contraindications

None listed.

5. Warnings and Precautions
  • Dermatologic Toxicity: Skin reactions in 35% (Grade 3 in 5%). Drug rash, dermatitis, eczema. Can be difficult to distinguish from underlying disease. May require biopsy.
  • Infusion-Related Reactions: In 35% (Grade 3 in 3%). Most during/after first infusion. Pre-medicate with diphenhydramine and acetaminophen.
  • Infections: Serious infections in 19% (fatal in 1%). Viral reactivation (HSV, HBV) reported.
  • Autoimmune Complications: Polymyositis, autoimmune hepatitis, pneumonitis reported due to T-reg depletion.
  • Complications of Allogeneic HSCT: Increased risk of transplant complications (severe GVHD, steroid-requiring febrile syndrome, hepatic VOD) if mogamulizumab given before allo-HSCT.
6. Adverse Reactions
Most Common Adverse Reactions

Rash (35%), infusion-related reactions (35%), fatigue (28%), diarrhea (23%), musculoskeletal pain (19%), upper respiratory tract infection (17%), drug eruption (14%), pyrexia (14%), headache (11%), peripheral edema (11%)

Rash
35%
Infusion-Related Reactions
35%
Fatigue
28%
Diarrhea
23%
Musculoskeletal Pain
19%
Upper Respiratory Tract Infection
17%
Drug Eruption
14%
Pyrexia
14%
Headache
11%
Peripheral Edema
11%

Consult the complete prescribing information for a comprehensive list of adverse reactions and their frequencies.

12. Clinical Pharmacology
Mechanism of Action

Mogamulizumab is a humanized IgG1ΞΊ monoclonal antibody with a defucosylated Fc region that binds to CC chemokine receptor 4 (CCR4). CCR4 is preferentially expressed on malignant T cells in cutaneous T-cell lymphomas (CTCL), particularly in SΓ©zary syndrome. The defucosylated Fc provides enhanced antibody-dependent cellular cytotoxicity (ADCC) against CCR4-positive malignant cells. CCR4 is also expressed on regulatory T cells (Tregs), so depletion of Tregs may contribute to additional anti-tumor immune responses.

Pharmacokinetics

Half-life: approximately 17 days. Steady-state by Cycle 3. Non-linear PK with target-mediated drug disposition at lower concentrations. Clearance: 0.37 L/day. Vd: 5.7 L.

14. Clinical Studies

Clinical efficacy and safety data supporting the approval are available in the full prescribing information and from the clinical trials listed below.

Pivotal Clinical Trials
Additional Resources
Approved Tumor Types
External Resources