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Moxetumomab pasudotox (United States: Withdrawn from market): Drug information

Moxetumomab pasudotox (United States: Withdrawn from market): Drug information
(For additional information see "Moxetumomab pasudotox (United States: Withdrawn from market): Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Special Alerts
Lumoxiti Planned Withdrawal from US Market January 2023

The manufacturer of Lumoxiti (moxetumomab pasudotox) injection, AstraZeneca, has issued a Dear Healthcare Provider letter on its decision to permanently discontinue Lumoxiti from the US market effective July 2023. AstraZeneca stated the decision was not based on product safety or efficacy. Providers should not initiate Lumoxiti therapy in new patients at this time and should assess the use of alternative therapies for patients currently receiving Lumoxiti prior to July 2023.

Further information can be found at https://www.fda.gov/media/164425/download.

ALERT: US Boxed Warning
Capillary leak syndrome:

Capillary leak syndrome (CLS), including life-threatening cases, occurred in patients receiving moxetumomab pasudotox. Monitor weight and blood pressure; check labs, including albumin, if CLS is suspected. Delay dosing or discontinue moxetumomab pasudotox as recommended.

Hemolytic uremic syndrome:

Hemolytic uremic syndrome (HUS), including life-threatening cases, occurred in patients receiving moxetumomab pasudotox. Monitor hemoglobin, platelet count, serum creatinine, and ensure adequate hydration. Discontinue moxetumomab pasudotox in patients with HUS.

Brand Names: US
  • Lumoxiti [DSC]
Pharmacologic Category
  • Antineoplastic Agent, Anti-CD22
Dosing: Adult

Note: Effective July 2023, the manufacturer will permanently discontinue moxetumomab pasudotox from the US market and it will not be available after August 2023. Moxetumomab pasudotox should not be initiated in new patients at this time; patients currently receiving moxetumomab pasudotox should have adequate time to complete the recommended 6 treatment cycles.

Hairy cell leukemia

Hairy cell leukemia (relapsed or refractory): IV: 0.04 mg/kg on days 1, 3, and 5 of each 28-day treatment cycle; continue for a maximum of 6 cycles, or until disease progression or unacceptable toxicity (Kreitman 2018).

Note: For the first treatment cycle, the dose should be calculated based on actual body weight. A dosage change should only be made between cycles if the patient's weight changes by >10% from the weight used to calculate the first dose of the first treatment cycle; do not change a dose during a particular cycle.

Concomitant treatments:

Hydration: Administer 1 L (500 mL for patients <50 kg) of isotonic IV solution over 2 to 4 hours before and after each moxetumomab pasudotox infusion. Patients should adequately hydrate with up to 3 L (2 L for patients <50 kg) of oral fluids (eg, water, milk or juice) per 24 hours on days 1 through 8 of each 28-day treatment cycle. Monitor fluid balance and serum electrolytes to avoid fluid overload and/or electrolyte imbalance.

Premedications: Administer an antihistamine (eg, hydroxyzine or diphenhydramine), an antipyretic (acetaminophen), and a histamine H2-receptor antagonist (eg, famotidine or cimetidine) 30 to 90 minutes prior to each moxetumomab pasudotox infusion.

Post-infusion medications: Administer an oral corticosteroid (eg, dexamethasone 4 mg) to decrease nausea and vomiting. Consider oral antihistamines and antipyretics for up to 24 hours following infusion. Maintain adequate oral fluid intake.

Thromboprophylaxis:Consider low-dose aspirin on days 1 through 8 of each 28-day treatment cycle.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

Renal impairment prior to treatment initiation:

CrCl ≥30 mL/minute: There are no dosage adjustments provided in the manufacturer's labeling; however, no clinically significant differences in the pharmacokinetics of moxetumomab pasudotox were observed in patients with CrCl 30 to 89 mL/minute.

CrCl ≤29 mL/minute: Use is not recommended.

Renal toxicity during treatment:

Grade 2 or higher creatinine increases (>1.5 times baseline or the upper limit of normal [ULN]): If baseline serum creatinine was within normal limits, delay infusion. Upon recovery to grade 1 (1 to 1.5 times baseline or between ULN to 1.5 times ULN), resume moxetumomab pasudotox treatment.

Grade 3 or higher creatinine increases (>3 times baseline or ULN): If baseline serum creatinine was grade 1 or 2, delay infusion. Upon recovery to baseline grade or lower, resume moxetumomab pasudotox treatment.

Dosing: Hepatic Impairment: Adult

Mild impairment (total bilirubin ≤ ULN and AST > ULN or total bilirubin >1 to 1.5 times ULN and any AST): There are no dosage adjustments provided in the manufacturer's labeling; however, no clinically significant differences in the pharmacokinetics of moxetumomab pasudotox were observed in patients with mild hepatic impairment.

Moderate to severe impairment (total bilirubin >1.5 times ULN): There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).

Dosing: Obesity: Adult

American Society of Clinical Oncology guidelines for appropriate systemic therapy dosing in adults with cancer with a BMI ≥30 kg/m2 : Utilize patient's actual body weight for calculation of BSA- or weight-based dosing; manage regimen-related toxicities in the same manner as for patients with a BMI <30 kg/m2; if a dose reduction is utilized due to toxicity, may consider resumption of full, weight-based dosing (or previously tolerated dose level) with subsequent cycles only if dose escalations are allowed in the prescribing information, if contributing underlying factors (eg, hepatic or kidney impairment) are sufficiently resolved, AND if performance status has markedly improved or is considered adequate (ASCO [Griggs 2021]). Note: According to the prescribing information, for the first treatment cycle, the dose should be calculated based on actual body weight; a dosage change should only be made between cycles if the patient's weight changes by >10% from the weight used to calculate the first dose of the first treatment cycle; do not change a dose during a particular cycle.

Dosing: Adjustment for Toxicity: Adult

Capillary leak syndrome (CLS):

Monitoring: Monitor weight and blood pressure prior to each infusion. If weight increased by 2.5 kg or ≥5% from day 1 of cycle and the patient is hypotensive, promptly monitor for peripheral edema, hypoalbuminemia, and respiratory symptoms, including dyspnea and cough. If CLS is suspected, monitor for decrease in oxygen saturation and evidence of pulmonary edema and/or serosal effusions. Patients who experience Grade 2 or higher CLS should receive appropriate supportive measures, including corticosteroids (oral or IV); monitor weight, albumin levels, and blood pressure until resolution.

Management:

Grade 2 (symptomatic; medical intervention indicated): Delay treatment until recovery of symptoms.

Grade 3 (severe symptoms; medical intervention indicated): Discontinue moxetumomab pasudotox.

Grade 4 (life-threatening consequences; urgent intervention indicated): Discontinue moxetumomab pasudotox.

Hemolytic uremic syndrome (HUS):

Monitoring: Monitor hemoglobin, platelets and serum creatinine prior to each infusion. If HUS is suspected, promptly monitor serum LDH, indirect bilirubin, and blood smear schistocytes for evidence of hemolysis.

Management: Discontinue moxetumomab pasudotox in patients with HUS. Manage with appropriate supportive measures and fluid replacement; monitor CBC, serum chemistries, and renal function until resolution.

Infusion reactions: Interrupt infusion for severe reactions and manage appropriately. Administer a corticosteroid (oral or IV) ~30 minutes prior to resuming infusion and prior to each subsequent infusion.

Dosing: Older Adult

Refer to adult dosing.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Cardiovascular: Peripheral edema (5% to 39%), capillary leak syndrome (≤34%), facial edema (14%)

Central nervous system: Fatigue (34%), headache (33%)

Endocrine & metabolic: Hypoalbuminemia (64%), fluid retention (1% to 63%), electrolyte disorder (57%), hypocalcemia (25% to 54%), hypophosphatemia (53%), hyponatremia (41%), hypokalemia (25%), increased gamma-glutamyl transferase (25%), hypomagnesemia (23%), hyperuricemia (21%)

Gastrointestinal: Nausea (35%), constipation (23%), diarrhea (21%), abdominal distention (13%)

Genitourinary: Nephrotoxicity (26%)

Hematologic & oncologic: Decreased hemoglobin (43%; grade 3: 15%), neutropenia (41%; grade 3: 11%; grade 4: 20%), anemia (21%; grade 3: 10%), decreased platelet count (21%; grade 3: 11%; grade 4: 4%)

Hepatic: Increased serum alanine aminotransferase (65%), increased serum aspartate aminotransferase (55%), increased serum bilirubin (30%), increased serum alkaline phosphatase (20%)

Renal: Increased serum creatinine (17% to 96%)

Miscellaneous: Infusion-related reaction (9% to 50%), fever (31%)

1% to 10%:

Cardiovascular: Edema (5%), pericardial effusion (1%)

Endocrine & metabolic: Weight gain (8%), hypervolemia (1%)

Genitourinary: Proteinuria (8%)

Hematologic & oncologic: Hemolytic-uremic syndrome (7%; grade 3: 3%; grade 4: <1%), febrile neutropenia (grades 3/4: ≤5%)

Hepatic: Ascites (1%)

Local: Localized edema (4%)

Ophthalmic: Blurred vision (9%), xerophthalmia (8%), cataract (5%), eye discomfort (≤4%), eye pain (≤4%), ocular edema (≤4%), periorbital edema (≤4%), conjunctival hemorrhage (1%), conjunctivitis (1%), eye discharge (1%)

Renal: Acute renal failure (2%), renal insufficiency (2%)

Respiratory: Pleural effusion (6%)

Frequency not defined: Immunologic: Antibody development

<1%, postmarketing, and/or case reports: Hemoconcentration, hypotension

Contraindications

There are no contraindications listed in the manufacturer's labeling.

Warnings/Precautions

Concerns related to adverse effects:

• Capillary leak syndrome: Capillary leak syndrome (CLS), including life-threatening cases, has occurred in patients receiving moxetumomab pasudotox. Monitor weight and blood pressure (prior to each infusion and as clinically indicated); monitor labs (including albumin) if CLS is suspected. May require treatment delay or discontinuation. CLS is characterized by hypoalbuminemia, hypotension, fluid overload symptoms, and hemoconcentration. Grade 2 CLS occurred more frequently, although grades 3 and 4 CLS have been observed. Most CLS cases occurred in the first 8 days (range: 1 to 19 days) of a treatment cycle; however, some cases have occurred throughout the treatment cycle. The median time to resolution of CLS was 12 days (range: 1 to 53 days). Monitor for hypoalbuminemia, elevated hematocrit, leukocytosis, and thrombocytosis, and monitor for signs/symptoms of CLS (weight gain [increase of 2.5 kg or ≥5% from day 1 of current cycle], hypotension, peripheral edema, shortness of breath/cough, pulmonary edema, and/or serosal effusions). Patients should be aware to seek immediate medication attention if signs/symptoms of CLS occur; CLS may be life-threatening or fatal if treatment is delayed. Manage CLS with appropriate supportive care, including concomitant oral or intravenous corticosteroids, and hospitalization as clinically indicated. Withhold moxetumomab pasudotox for grade 2 CLS until resolution; permanently discontinue for grade 3 or higher CLS.

• Electrolyte abnormality: Electrolyte abnormalities occurred in over half of patients treated with moxetumomab pasudotox (including grade 3 and 4 events). Hypocalcemia was the most common electrolyte abnormality. Electrolyte abnormalities have commonly occurred within the same treatment cycle as CLS, HUS, fluid retention, or renal toxicity. Monitor serum electrolytes prior to each dose and on day 8 of each treatment cycle; mid-cycle monitoring is also recommended.

• Hemolytic uremic syndrome: Hemolytic uremic syndrome (HUS), including life-threatening cases, has occurred in patients receiving moxetumomab pasudotox. Monitor hemoglobin, platelet count, serum creatinine, and ensure adequate hydration. Discontinue moxetumomab pasudotox in patients with HUS. HUS is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and progressive renal failure. Grades 3 and 4 HUS have been observed. Most HUS cases occurred in the first 9 days (range: 1 to 16 days) of a treatment cycle; however, cases have been reported throughout the cycle. All cases of HUS resolved, including those where treatment was discontinued. The median time to resolution of HUS was 11.5 days (range: 2 to 44 days). Avoid moxetumomab pasudotox in patients with history of severe thrombotic microangiopathy (TMA) or HUS. Administer prophylactic IV fluids prior to and following moxetumomab pasudotox infusions. In one clinical trial, patients with a platelet count ≥100,000/mm3 received low-dose aspirin for thrombosis prophylaxis on days 1 through 8 of each 28-day treatment cycle. Monitor CBC and serum chemistries prior to each dose and on day 8 of each treatment cycle; mid-cycle monitoring is also recommended. Consider the diagnosis of HUS in patients who develop hemolytic anemia, worsening thrombocytopenia (or sudden onset), increased serum creatinine, bilirubin and/or LDH elevations, and have evidence of hemolysis based on peripheral blood smear schistocytes. HUS events may be life-threatening if treatment is delayed, with increased risk of progressive renal failure requiring dialysis. If HUS is suspected, initiate appropriate supportive measures, including fluid repletion, hemodynamic monitoring, and consider hospitalization as clinically indicated. Discontinue moxetumomab pasudotox in patients with HUS.

• Infusion reactions: Infusion-related reactions have occurred in half of patients who received moxetumomab pasudotox; grade 3 infusion reaction has been reported. Infusion-related reactions may occur during any treatment cycle. Infusion reactions included chills, fever, dizziness, cough, dyspnea, feeling hot, flushing, headache, hyper-/hypotension, myalgia, nausea, vomiting, tachycardia (including sinus tachycardia), or wheezing; the most frequently reported infusion-related events were nausea, vomiting, fever, chills, and headache. Premedicate with antihistamines and antipyretics prior to each moxetumomab pasudotox dose. If a severe infusion-related reaction occurs, interrupt the infusion and institute appropriate medical management; administer a corticosteroid (oral or IV) ~30 minutes before resuming the infusion, and before the next moxetumomab pasudotox infusion.

• Renal toxicity: Renal toxicity has been reported in patients treated with moxetumomab pasudotox, including acute kidney injury (including grade 3 events), renal failure, renal impairment, elevated serum creatinine, and proteinuria. Most renal toxicity events were mild to moderate in severity. Serum creatinine increased by 2 or more grades (from baseline) during treatment, including grade 3 increases, in some patients. Serum creatinine remained elevated (1.5 to 3 times the upper limit of normal) at the end of treatment in a small percentage of patients. Patients ≥65 years of age, with baseline renal impairment, or who experience HUS may be at an increased risk for worsening of renal function following moxetumomab pasudotox treatment. Monitor renal function prior to each infusion and as clinically indicated throughout treatment. Delay dosing in patients with grade 3 or higher serum creatinine elevations or if worsens from baseline by ≥2 grades.

Special populations:

• Older adult: Patients ≥65 years of age may have a higher incidence of adverse reactions leading to discontinuation and renal toxicity.

Dosage form specific issues:

• Polysorbate 80: Some dosage forms may contain polysorbate 80 (also known as Tweens). Hypersensitivity reactions, usually a delayed reaction, have been reported following exposure to pharmaceutical products containing polysorbate 80 in certain individuals (Isaksson 2002; Lucente 2000; Shelley 1995). Thrombocytopenia, ascites, pulmonary deterioration, and renal and hepatic failure have been reported in premature neonates after receiving parenteral products containing polysorbate 80 (Alade 1986; CDC 1984). See manufacturer's labeling.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution Reconstituted, Intravenous:

Lumoxiti: 1 mg (1 ea [DSC]) [contains polysorbate 80]

Solution Reconstituted, Intravenous [preservative free]:

Lumoxiti: 1 mg (1 ea [DSC]) [contains polysorbate 80]

Generic Equivalent Available: US

No

Pricing: US

Solution (reconstituted) (Lumoxiti Intravenous)

1 mg (per each): $2,648.40

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

IV: Infuse over 30 minutes. Do not infuse with other medications. Flush the infusion line with normal saline (at the same rate as the infusion) following the infusion to ensure entire dose is delivered. Premedicate 30 to 90 minutes prior to each moxetumomab pasudotox infusion with an antihistamine, acetaminophen, and a histamine-2 receptor antagonist. Maintain adequate hydration.

Medication Guide and/or Vaccine Information Statement (VIS)

An FDA-approved patient medication guide, which is available with the product information and as follows, must be dispensed with this medication:

Lumoxiti: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/761104s003lbl.pdf#page=18

Use: Labeled Indications

Hairy cell leukemia (relapsed or refractory): Treatment of relapsed or refractory hairy cell leukemia (HCL) in adults who have received at least 2 prior systemic therapies, including treatment with a purine nucleoside analog.

Limitations of use: Moxetumomab pasudotox is not recommended in patients with severe renal impairment (CrCl ≤29 mL/minute).

Note: Effective July 2023, the manufacturer will permanently discontinue moxetumomab pasudotox from the US market and it will not be available after August 2023. Moxetumomab pasudotox should not be initiated in new patients at this time; patients currently receiving moxetumomab pasudotox should have adequate time to complete the recommended 6 treatment cycles.

Medication Safety Issues
Sound-alike/look-alike issues:

Moxetumomab pasudotox may be confused with mepolizumab, mogamulizumab, mosunetuzumab.

High alert medication:

This medication is in a class the Institute for Safe Medication Practices (ISMP) includes among its list of drug classes which have a heightened risk of causing significant patient harm when used in error.

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

5-Aminosalicylic Acid Derivatives: May enhance the myelosuppressive effect of Myelosuppressive Agents. Risk C: Monitor therapy

BCG (Intravesical): Myelosuppressive Agents may diminish the therapeutic effect of BCG (Intravesical). Risk X: Avoid combination

Chloramphenicol (Ophthalmic): May enhance the adverse/toxic effect of Myelosuppressive Agents. Risk C: Monitor therapy

Chloramphenicol (Systemic): Myelosuppressive Agents may enhance the myelosuppressive effect of Chloramphenicol (Systemic). Risk X: Avoid combination

Cladribine: May enhance the myelosuppressive effect of Myelosuppressive Agents. Risk X: Avoid combination

CloZAPine: Myelosuppressive Agents may enhance the adverse/toxic effect of CloZAPine. Specifically, the risk for neutropenia may be increased. Risk C: Monitor therapy

Deferiprone: Myelosuppressive Agents may enhance the neutropenic effect of Deferiprone. Management: Avoid the concomitant use of deferiprone and myelosuppressive agents whenever possible. If this combination cannot be avoided, monitor the absolute neutrophil count more closely. Risk D: Consider therapy modification

Desmopressin: Hyponatremia-Associated Agents may enhance the hyponatremic effect of Desmopressin. Risk C: Monitor therapy

Dipyrone: May enhance the adverse/toxic effect of Myelosuppressive Agents. Specifically, the risk for agranulocytosis and pancytopenia may be increased Risk X: Avoid combination

Fexinidazole: Myelosuppressive Agents may enhance the myelosuppressive effect of Fexinidazole. Risk X: Avoid combination

Olaparib: Myelosuppressive Agents may enhance the myelosuppressive effect of Olaparib. Risk C: Monitor therapy

Promazine: May enhance the myelosuppressive effect of Myelosuppressive Agents. Risk C: Monitor therapy

Ropeginterferon Alfa-2b: Myelosuppressive Agents may enhance the myelosuppressive effect of Ropeginterferon Alfa-2b. Management: Avoid coadministration of ropeginterferon alfa-2b and other myelosuppressive agents. If this combination cannot be avoided, monitor patients for excessive myelosuppressive effects. Risk D: Consider therapy modification

Reproductive Considerations

Evaluate pregnancy status prior to use. The manufacturer recommends patients who could become pregnant use effective contraception during treatment and for at least 30 days after the last dose of moxetumomab pasudotox.

Pregnancy Considerations

Based on the mechanism of action and adverse events observed in nonpregnant animal studies, adverse maternal and fetal events may be expected if exposure occurs during pregnancy.

Breastfeeding Considerations

It is not known if moxetumomab pasudotox is present in breast milk.

Breastfeeding is not recommended by the manufacturer; the decision to discontinue moxetumomab pasudotox or to discontinue breastfeeding during therapy should consider the benefits of breastfeeding to the infant versus the benefits of treatment to the mother.

Monitoring Parameters

Monitor CBC and serum chemistries prior to each dose and on day 8 of each treatment cycle; mid-cycle monitoring is also recommended. Monitor renal function prior to each infusion and as clinically indicated throughout treatment. Evaluate pregnancy status (prior to therapy initiation in females of reproductive potential). Monitor weight and blood pressure (prior to each infusion and as clinically indicated) and monitor labs (including albumin) if CLS is suspected. Monitor for signs/symptoms of CLS (weight gain [increase of 2.5 kg or ≥5% from day 1 of current cycle, hypotension, peripheral edema, shortness of breath/cough, pulmonary edema and/or serosal effusions). In patients suspected to have HUS, monitor for serum creatinine, bilirubin and/or LDH elevations, and for evidence of hemolysis based on peripheral blood smear schistocytes. Monitor for signs/symptoms of infusion reactions, thrombosis, and fluid overload.

The American Society of Clinical Oncology hepatitis B virus (HBV) screening and management provisional clinical opinion (ASCO [Hwang 2020]) recommends HBV screening with hepatitis B surface antigen, hepatitis B core antibody, total Ig or IgG, and antibody to hepatitis B surface antigen prior to beginning (or at the beginning of) systemic anticancer therapy; do not delay treatment for screening/results. Detection of chronic or past HBV infection requires a risk assessment to determine antiviral prophylaxis requirements, monitoring, and follow-up.

Mechanism of Action

Moxetumomab pasudotox is a CD22-directed cytotoxin composed of a recombinant murine immunoglobulin genetically fused to truncated Pseudomonas exotoxin (PE38). Moxetumomab pasudotox binds CD22 on the cell surface of B-cells and is internalized. Moxetumomab pasudotox internalization results in ADP-ribosylation of elongation factor 2, inhibition of protein synthesis, and apoptotic cell death.

Pharmacokinetics (Adult Data Unless Noted)

Onset: Achievement of hematologic remission: ~1 month (Kreitman 2018). Day 8 circulating CD19+ B cells (surrogate assay for CD22) were reduced 89% (from baseline) following the first 3 infusions.

Duration: Median duration of complete response (for patients with minimal residual disease): 5.9 months (Kreitman 2018). B cell reduction is sustained for at least 1 month after treatment.

Distribution: Vd: 6.5 L

Half-life elimination: 1.4 hours (range: 0.8 to 1.8 hours)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Antibody formation: In patients who were anti-product antibody (ADA)-positive with high titers, the presence of ADA post-baseline was associated with statistically significantly lower PK exposure (Cmax) starting at cycle 3 and beyond.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (BR) Brazil: Lumoxiti;
  • (PL) Poland: Lumoxiti;
  • (PR) Puerto Rico: Lumoxiti;
  • (SE) Sweden: Lumoxiti
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  3. Centers for Disease Control and Prevention (CDC). Unusual syndrome with fatalities among premature infants: association with a new intravenous vitamin E product. MMWR Morb Mortal Wkly Rep. 1984;33(14):198-199. [PubMed 6423951]
  4. Griggs JJ, Bohlke K, Balaban EP, et al. Appropriate systemic therapy dosing for obese adult patients with cancer: ASCO guideline update. J Clin Oncol. 2021;39(18):2037-2048 doi:10.1200/JCO.21.00471 [PubMed 33939491]
  5. Hwang JP, Feld JJ, Hammond SP, et al. Hepatitis B virus screening and management for patients with cancer prior to therapy: ASCO provisional clinical opinion update. J Clin Oncol. 2020;38(31):3698-3715. doi:10.1200/JCO.20.01757 [PubMed 32716741]
  6. Isaksson M, Jansson L. Contact allergy to Tween 80 in an inhalation suspension. Contact Dermatitis. 2002;47(5):312-313. [PubMed 12534540]
  7. Kreitman RJ, Dearden C, Zinzani PL, et al. Moxetumomab pasudotox in relapsed/refractory hairy cell leukemia. Leukemia. 2018;32(8):1768-1777. doi: 10.1038/s41375-018-0210-1. [PubMed 30030507]
  8. Lucente P, Iorizzo M, Pazzaglia M. Contact sensitivity to Tween 80 in a child. Contact Dermatitis. 2000;43(3):172. [PubMed 10985636]
  9. Lumoxiti (moxetumomab pasudotox-tdfk) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; February 2022.
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