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Moxetumomab pasudotox is a CD22-directed recombinant immunotoxin. It consists of a murine anti-CD22 antibody variable fragment (Fv) fused to a 38 kDa fragment of Pseudomonas exotoxin A (PE38). The drug targets CD22, a surface antigen highly expressed on B-cell malignancies. Upon binding to CD22, the immunotoxin is internalized, and the PE38 moiety catalyzes the ADP-ribosylation of elongation factor 2, leading to the inhibition of protein synthesis and subsequent apoptosis of the target cell. Originally developed by Cambridge Antibody Technology and later by MedImmune (AstraZeneca), it is marketed as Lumoxiti for relapsed or refractory hairy cell leukemia. It has also been investigated in clinical trials for other B-cell malignancies, including chronic lymphocytic leukemia (CLL), prolymphocytic leukemia (PLL), and small lymphocytic lymphoma (SLL).
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