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How it is administered
Brentuximab vedotin is given as an intravenous (IV) infusion. It is supplied as a sterile, preservative-free powder that is reconstituted and diluted before being administered over 30 minutes. The dosing schedule and amount depend on the specific indication and whether it is used alone or in combination with other chemotherapy agents. For anaplastic large cell lymphoma (ALCL), the typical dose is 1.8 mg/kg (up to a maximum of 180 mg) every 3 weeks, either as monotherapy or in combination with chemotherapy, for a set number of cycles or until disease progression or unacceptable toxicity.
How it works
Brentuximab vedotin is a targeted therapy known as an antibody-drug conjugate. It combines a monoclonal antibody that specifically recognizes the CD30 protein (commonly found on the surface of certain lymphoma cells, including ALCL) with a potent cell-killing agent called MMAE. When brentuximab vedotin binds to CD30 on cancer cells, it is taken into the cell, where the MMAE is released. MMAE disrupts the microtubule network inside the cell, leading to cell cycle arrest and programmed cell death (apoptosis). This targeted approach helps to kill cancer cells while minimizing effects on most normal cells, as CD30 is not widely expressed in healthy tissues.
Common side effects
- Peripheral neuropathy (numbness, tingling, or weakness in hands or feet)
- Nausea and vomiting
- Fatigue
- Constipation or diarrhea
- Fever
- Upper respiratory tract infection
- Muscle and joint pain
- Rash
- Abdominal pain
- Decreased appetite
- Infusion-related reactions (chills, fever, rash, breathing problems)
- Blood count changes (neutropenia, anemia, thrombocytopenia)
- Elevated liver enzymes
- Increased blood sugar
Patients should promptly report any new or worsening symptoms to their healthcare provider.
Who Should take it
Brentuximab vedotin is indicated for adults with previously untreated or relapsed systemic anaplastic large cell lymphoma (sALCL) and other CD30-expressing peripheral T-cell lymphomas, in combination with chemotherapy or as monotherapy after failure of prior regimens. It is also used in other blood cancers, such as classical Hodgkin lymphoma and certain cutaneous lymphomas, when other treatments have not worked or as part of initial therapy in combination with other drugs. The decision to use brentuximab vedotin is based on the type of lymphoma, the presence of CD30 on cancer cells, previous treatments, and overall health.
Who should not take it
Brentuximab vedotin should not be used in patients who are allergic to any of its components. It is contraindicated for use with bleomycin due to the risk of severe lung toxicity. Patients with severe renal impairment or moderate to severe liver impairment should generally avoid this medication, as it can increase the risk of serious side effects. Pregnant women should not take brentuximab vedotin because it can harm the unborn baby. Patients with active infections or certain pre-existing conditions may need to delay or avoid treatment based on their doctor's assessment.
Commonly used with
For anaplastic large cell lymphoma and other CD30-expressing lymphomas, brentuximab vedotin is often used in combination with chemotherapy agents such as cyclophosphamide, doxorubicin, and prednisone (the CHP regimen). It may also be combined with other drugs depending on the specific type of lymphoma and treatment protocol. Growth factor support (such as G-CSF) is commonly given to reduce the risk of neutropenia (low white blood cell counts).
Commonly tested with
Brentuximab vedotin has been tested in combination with various chemotherapy regimens, including CHP (cyclophosphamide, doxorubicin, prednisone) for previously untreated ALCL and other T-cell lymphomas. It has also been studied with AVD (doxorubicin, vinblastine, dacarbazine) for Hodgkin lymphoma, and in combination with lenalidomide and rituximab for large B-cell lymphoma. These combinations are designed to improve treatment outcomes in blood cancers.