**6.5 Inotuzumab ozogamicin for Philadelphia+ ALL**

Like gemtuzumab ozogamicin, inotuzumab ozogamicin (Besponsa), an antibody/chemotherapy conjugate that internalizes into the tumor cells upon binding to CD22 on the cell surface. "It's carrying a CD22 Trojan horse to the cell, discharging the payload there (the microtubule-targeting agent calicheamicin) is a highly potent chemotherapeutic drug belonging to the enediyne class of DNA-damaging cytotoxic agents derived from the soil bacterium *Micromonospora echinospora* ssp. calichensis*.*" Inotuzumab looks encouraging in a number of lymphomas, yet it came to advertise first for relapsed or refractory B-ALL patients. The pivotal multicenter stage III preliminary selected 326 patients with refractory or relapsed ALL CD22+, randomizing them to a standard treatment or inotuzumab ozogamicin [33]. Its recent approval has greatly increased the ability to attain remission long period and represents a significant advance in therapeutic options for treatment of relapsed ALL.

## **6.6 Copanlisib for follicular lymphoma**

In September, 2017, Copanlisib *was* approved *by the FDA* used to treat of adult patients with recurrent low grade follicular lymphoma who have received at least two previous chemotherapies. Copanlisib is a class I phosphatidylinositol 3-kinase (PI3K) inhibitor with a predominance of PI3K-α and PI3K-δ activity present in cancerous B cells [34].

## **6.7 Ibrutinib in chronic graft-vs.-host disease (GVHD)**

In 2017, ibrutinib (Imbruvica) was approved as the first drug for GVHD after corticosteroid therapies response failure. Ibrutinib is a small-molecule of the B-cell antigen receptor inhibits cell proliferation, and promotes apoptosis of cancer cells through inhibition of Bruton's tyrosine kinase. The daily oral dose of 420 mg with median time response of 12 weeks and overall response rate about 67% [35].
