How it is administered

Brentuximab vedotin is administered as an intravenous (IV) infusion. It is given over 30 minutes and should not be given as a rapid intravenous push or bolus. The medication comes as a sterile, white to off-white powder that is reconstituted and diluted before administration. The dose and frequency depend on the specific indication and patient characteristics, such as body weight and combination with other therapies.

For relapsed or refractory large B-cell lymphoma (LBCL), including diffuse large B-cell lymphoma (DLBCL), the recommended dose is 1.2 mg/kg (up to a maximum of 120 mg) every 3 weeks, in combination with lenalidomide and rituximab. The number of cycles and duration of therapy depend on response and tolerability.

How it works

Brentuximab vedotin is an antibody-drug conjugate (ADC) designed to target and kill cancer cells. It consists of three main parts: a monoclonal antibody that specifically binds to a protein called CD30, which is found on the surface of certain lymphoma cells; a potent chemotherapy drug called monomethyl auristatin E (MMAE); and a linker that connects the two.

Once brentuximab vedotin binds to CD30 on the cancer cell, the entire complex is taken into the cell. Inside the cell, the linker is broken down, releasing MMAE. MMAE then disrupts the cell’s internal skeleton (microtubules), which is essential for cell division. This disruption causes the cancer cell to stop dividing and eventually die. Additionally, the antibody part of brentuximab vedotin may help the immune system recognize and destroy the cancer cell.

Who Should take it

Brentuximab vedotin is indicated for adults with relapsed or refractory large B-cell lymphoma (LBCL), including diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL), who have received at least two prior lines of systemic therapy and are not eligible for autologous stem cell transplant (auto-HSCT) or CAR T-cell therapy. It is used in combination with lenalidomide and rituximab for these patients.

It is also approved for several other types of blood cancers, such as classical Hodgkin lymphoma (cHL), systemic anaplastic large cell lymphoma (sALCL), and certain peripheral T-cell lymphomas, in various combinations and settings. The specific use and combination depend on the type and stage of lymphoma, prior treatments, and patient factors.

Who should not take it

Brentuximab vedotin should not be used in combination with bleomycin due to the risk of severe lung toxicity. It should be avoided in patients with severe renal impairment (creatinine clearance <30 mL/min) and in those with moderate or severe hepatic impairment, as these conditions can increase the risk of serious side effects.

Patients with known hypersensitivity to brentuximab vedotin or any of its components should not receive this medication. It is also not recommended for use during pregnancy, as it can cause harm to the unborn baby, or during breastfeeding. Patients with active, serious infections or significant peripheral neuropathy should discuss risks and benefits with their healthcare provider.

Commonly used with

For relapsed or refractory large B-cell lymphoma, brentuximab vedotin is commonly used in combination with lenalidomide and rituximab. In other types of lymphoma, it may be combined with chemotherapy agents such as doxorubicin, vinblastine, dacarbazine, cyclophosphamide, prednisone, and etoposide, depending on the specific disease and treatment setting.

Growth factor support (such as G-CSF) is often used to reduce the risk of neutropenia (low white blood cell counts) when brentuximab vedotin is given with chemotherapy.

Commonly tested with

Brentuximab vedotin has been tested in combination with:

• Lenalidomide and rituximab (for relapsed/refractory LBCL)
• Doxorubicin, vinblastine, and dacarbazine (for Hodgkin lymphoma)
• Cyclophosphamide, doxorubicin, and prednisone (for peripheral T-cell lymphomas)
• Vincristine, etoposide, prednisone, and cyclophosphamide (for pediatric Hodgkin lymphoma)

These combinations have been studied in clinical trials to determine their safety and effectiveness for different types of blood cancers.