Axatilimab (Niktimvo®) in chronic graft-versus-host disease: a profile of its use
摘要
Axatilimab (axatilimab-csfr; Niktimvo®), an anti-colony stimulating factor 1 receptor (CSF1R) monoclonal antibody, is a useful addition to treatment options in the USA for chronic graft-versus-host disease (cGVHD) in patients weighing ≥ 40 kg who have failed ≥ two prior lines of systemic therapy. It acts through a novel mechanism, inhibiting macrophage activation and differentiation via CSF1R blockade. In the AGAVE-201 clinical trial, axatilimab 0.3 mg/kg once every 2 weeks improves patient condition and reduces patient-reported symptom severity. While no patients achieved overall complete responses, responses were observed in all affected organs, including organs with difficult-to-treat fibrotic manifestations. The tolerability profile of axatilimab at the approved dosage was generally manageable. Infections were the most common adverse events, and laboratory abnormalities caused by CSF1R blockade were transient and not associated with end-organ damage. Current evidence is limited by the small patient population and open-label phase 2 trial design; results from ongoing clinical trials of axatilimab in cGVHD are awaited with interest.