Brentuximab vedotin (trade name Adcetris) is an antibody-drug conjugate (ADC) medication consisting of the monoclonal antibody cAC10 and the cytotoxic agent MMAE used to treat relapsed or refractory Hodgkin lymphoma (HL) and systemic anaplastic large cell lymphoma (ALCL). cAC10 (SGN-30) is a chimeric anti-CD30 monoclonal antibody that is derived from the fusion of the variable heavy and light region of the murine anti-CD30 antibody AC10, with the constant γ1-heavy and κ-light region of the human immunoglobulin. MMAE is a synthetic derivative of dolastatin 10, a cytostatic pseudopeptide isolated from the marine shell-less mollusk Dorabella auricularia. MMAE has the effect of cytostasis, tubulin-dependent GTP hydrolysis, and polymerization. Brentuximab vedotin was initially approved in 2011. In January 2012, the drug label was revised with a boxed warning of a condition known as progressive multifocal leukoencephalopathy and death due to opportunistic JC virus infection post treatment. The U.S. Food and Drug Administration approved Adcetris in March 2018 to treat adult patients with previously untreated stage III or IV classical Hodgkin lymphoma (cHL) in combination with chemotherapy.
Hodgkin Lymphoma (HL) accounts for10% of all lymphomas and 0.6% of all cancers in the developed world. HL is histologically defined by rare mononuclear Hodgkin cells and multinucleated Reed-Stemberg (HRS) cells residing in a sea of inflammatory cells. HRS cells are derived from germinal center B cells, but phenotypically lose the expression of typical B cell markers. Despite an excellent cure rate with modern frontline HL therapy, approximately 15% to 20% of patients are not cured with first line or second line therapy and will require additional treatments. HRS cells are characterized by the expression of CD30 receptors. CD30 is a transmembrane glycoprotein that belongs to the tumor necrosis factor (TNF) receptor superfamily. In normal tissue, CD30 expression is restricted to activated T and activated B cells which makes it an ideal therapeutic target for monoclonal antibodies. Brentuximab vedotin is an antibody-drug conjugate (ADC) that was developed by conjugating the tubulin toxin monomethyl auristatin E (MMAE) to the chimeric monoclonal anti-CD30 antibody cAC10. On average, four molecules of MMAE are conjugated to one cAC10. After binding to CD30, brentuximab vedotin in internalized and processed into lysosomal vesicles leading to the release of MMAE from the antibody by reduction or acid hydrolysis within the lysosomes. Subsequently, MMAE is released into cytoplasm and inhibits microtubule polymerization leading to cell cycle arrest followed by cell death. As HRS cells die, a small amount of MMAE is released into the tumor microenvironment which can kill neighboring cells by a CD30-independent manner.
Fig 1. Mechanism of Action of Brentuximab vedotin
Table 1. Clinical Projects of Brentuximab vedotin*
NCT ID | Status | Conditions | Lead Sponsor | Update Time |
NCT03007030 | Recruiting | Lung Diseases Due to External Agents, Mesothelioma | M.D. Anderson Cancer Center | December 30, 2016 |
NCT02388490 | Active, not recruiting | Relapsed or Refractory EBV-and CD30-positive Lymphomas | Seoul National University Hospital | March 17, 2015 |
NCT03302728 | Not yet recruiting | Lymphoma, T-Cell, Cutaneous; Lymphoma, T-Cell, Peripheral; Hodgkin Lymphoma | Peter MacCallum Cancer Centre, Australia | October 5, 2017 |
NCT02164006 | Active, not recruiting | Hodgkin's Lymphoma | TG Therapeutics, Inc. | June 16, 2014 |
NCT03474133 | Not yet recruiting | Hodgkin's Lymphoma | Federal Research Institute of Pediatric Hematology, Oncology and Immunology | March 22, 2018 |
NCT02497131 | Recruiting | Lymphatic Diseases | Fondazione Italiana Linfomi ONLUS | July 14, 2015 |
NCT01990534 | Active, not recruiting | Hodgkin Lymphoma | Millennium Pharmaceuticals, Inc. | November 21, 2013 |
NCT03729609 | Recruiting | Untreated CD30-Positive Hodgkin's Lymphoma | Takeda | November 2, 2018 |
NCT01909934 | Recruiting | Anaplastic Large-cell Lymphoma | Millennium Pharmaceuticals, Inc. | July 29, 2013 |
NCT03587844 | Recruiting | Mycosis Fungoides, Lymphomatoid Papulosis, Sezary Syndrome | Memorial Sloan Kettering Cancer Center | July 16, 2018 |
NCT02462538 | Active, not recruiting | ALK+ Anaplastic Large Cell Lymphoma | Arbeitsgemeinschaft medikamentoese Tumortherapie | June 4, 2015 |
NCT02939014 | Active, not recruiting | Hodgkin Disease, Lymphoma, Large-Cell, Anaplastic | Takeda | October 19, 2016 |
NCT01700751 | Active, not recruiting | Leukemia, Acute Myeloid; Leukemia, Lymphoblastic,Acute; Myelodysplastic Syndromes | Washington University School of Medicine | October 4, 2012 |
NCT02572167 | Active, not recruiting | Hodgkin Lymphoma | Seattle Genetics, Inc. | October 8, 2015 |
NCT02429375 | Active, not recruiting | Hodgkin Lymphoma | Memorial Sloan Kettering Cancer Center | April 29, 2015 |
NCT02227433 | Active, not recruiting | Hodgkin Lymphoma | Fondazione Italiana Linfomi ONLUS | August 28, 2014 |
NCT02588651 | Recruiting | T-cell Lymphoma, Angioimmunoblastic T-cell Lymphoma, Hepato-splenic T-cell Lymphoma, Adult T-cell Leukemia/Lymphoma, Enteropathy Associated T-cell Lymphoma, NK T-cell Lymphoma, Transformed Mycosis Fungoides | Deepa Jagadeesh | October 28, 2015 |
NCT03222492 | Recruiting | Diffuse Cutaneous Systemic Sclerosis, Scleroderma, dcSSc | National Institute of Allergy and Infectious Diseases (NIAID) | July 19, 2017 |
NCT02979522 | Recruiting | Hodgkin Disease | Millennium Pharmaceuticals, Inc. | December 1, 2016 |
NCT03187210 | Recruiting | Lymphoma | University Hospital Inselspital, Berne | June 14, 2017 |
NCT03496779 | Recruiting | Refractory Peripheral T-Cell Lymphoma, Relapsed Peripheral T-Cell Lymphoma | The Lymphoma Academic Research Organisation | April 12, 2018 |
NCT02689219 | Recruiting | Germ Cell Tumors, Testis Cancer, Testicular Cancer, Embryonal Carcinoma, Nonseminomatous Germ Cell Tumor | Costantine Albany | February 23, 2016 |
NCT03198689 | Not yet recruiting | Diffuse Cutaneous Systemic Sclerosis | Lawson Health Research Institute | June 26, 2017 |
NCT01508312 | Active, not recruiting | Hodgkin's Lymphoma | Memorial Sloan Kettering Cancer Center | January 11, 2012 |
NCT01657331 | Active, not recruiting | Hodgkin Lymphoma, Anaplastic Large Cell Lymphoma | Owen A. O'Connor | August 6, 2012 |
NCT02581631 | Recruiting | Non-Hodgkin's Disease | Bristol-Myers Squibb | October 21, 2015 |
NCT01780662 | Active, not recruiting | Recurrent Adult Hodgkin Lymphoma, Recurrent Childhood Hodgkin Lymphoma, Refractory Childhood Hodgkin Lymphoma | National Cancer Institute (NCI) | January 31, 2013 |
NCT03356054 | Not yet recruiting | DLBCL | Stichting Hemato-Oncologie voor Volwassenen Nederland | November 29, 2017 |
NCT01100502 | Active, not recruiting | Disease, Hodgkin | Seattle Genetics, Inc. | April 9, 2010 |
NCT02254239 | Active, not recruiting | Recurrent Hodgkin Lymphoma, Refractory Hodgkin Lymphoma | Mayo Clinic | October 1, 2014 |
NCT02467946 | Recruiting | Clinical Efficacy, Safety | Centre Antoine Lacassagne | June 10, 2015 |
NCT01578967 | Active, not recruiting | Hodgkin Lymphoma, Adult | UNC Lineberger Comprehensive Cancer Center | April 17, 2012 |
NCT02086604 | Active, not recruiting | Lymphoma, Large B-Cell, Diffuse | Washington University School of Medicine | March 13, 2014 |
NCT03373305 | Not yet recruiting | CD30-Positive Neoplastic Cells Present, Folliculotropic Mycosis Fungoides, Recurrent Mycosis Fungoides, Recurrent Primary Cutaneous T-Cell Non-Hodgkin Lymphoma, Refractory Mycosis Fungoides, Refractory Primary Cutaneous T-Cell Non-Hodgkin Lymphoma, Sezary Syndrome | City of Hope Medical Center | December 14, 2017 |
NCT03409432 | Recruiting | Lymphomatoid Papulosis, Primary Cutaneous Anaplastic Large Cell Lymphoma, Recurrent Primary Cutaneous T-Cell Non-Hodgkin Lymphoma, Recurrent T-Cell Non-Hodgkin Lymphoma, Refractory Primary Cutaneous T-Cell Non-Hodgkin Lymphoma, Stage I Cutaneous T-Cell Non-Hodgkin Lymphoma, Stage II Cutaneous T-Cell Non-Hodgkin Lymphoma, Stage III Cutaneous T-Cell Non-Hodgkin Lymphoma, Stage IV Cutaneous T-Cell Non-Hodgkin Lymphoma | Basem William, MD | January 24, 2018 |
NCT01830777 | Active, not recruiting | Acute Myelogenous Leukemia | Massachusetts General Hospital | April 12, 2013 |
NCT02729961 | Recruiting | Anaplastic Large Cell Lymphoma, ALK-Positive, CD30-Positive Neoplastic Cells Present, Systemic Anaplastic Large Cell Lymphoma | University of Washington | April 6, 2016 |
NCT01352520 | Active, not recruiting | CD-30 Positive Anaplastic Large T-cell Cutaneous Lymphoma, Lymphoma, Primary Cutaneous Anaplastic Large Cell, Lymphomatoid Papulosis, Mycosis Fungoides, Skin Lymphoma, Cutaneous Lymphomas, Lymphoma, Hematologic Disorder | M.D. Anderson Cancer Center | May 12, 2011 |
NCT02298257 | Active, not recruiting | HIV Infection, HIV-associated Hodgkin Lymphoma, Stage III Adult Hodgkin Lymphoma, Stage IV Adult Hodgkin Lymphoma | The Lymphoma Academic Research Organisation | November 21, 2014 |
NCT03057795 | Recruiting | Classical Hodgkin Lymphoma, Hematopoietic Cell Transplantation Recipient, Recurrent Hodgkin Lymphoma, Refractory Hodgkin Lymphoma | City of Hope Medical Center | February 20, 2017 |
NCT02758717 | Recruiting | Ann Arbor Stage IB Hodgkin Lymphoma, Ann Arbor Stage II Hodgkin Lymphoma, Ann Arbor Stage IIA Hodgkin Lymphoma, Ann Arbor Stage IIB Hodgkin Lymphoma, Ann Arbor Stage III Hodgkin Lymphoma, Ann Arbor Stage IIIA Hodgkin Lymphoma, Ann Arbor Stage IIIB Hodgkin Lymphoma, Ann Arbor Stage IV Hodgkin Lymphoma, Ann Arbor Stage IVA Hodgkin Lymphoma, Ann Arbor Stage IVB Hodgkin Lymphoma, Classic Hodgkin Lymphoma | Academic and Community Cancer Research United | May 2, 2016 |
NCT02499627 | Recruiting | Lymphatic Diseases | Fondazione Italiana Linfomi ONLUS | July 16, 2015 |
NCT02616965 | Recruiting | Cutaneous T-cell Lymphoma (CTCL) | Fox Chase Cancer Center | November 30, 2015 |
NCT03652441 | Not yet recruiting | Classical Hodgkin Lymphoma | University of Cologne | August 29, 2018 |
NCT02684292 | Active, not recruiting | Hodgkin Lymphoma | Merck Sharp & Dohme Corp. | February 17, 2016 |
NCT03138499 | Recruiting | Hodgkin's Disease | Bristol-Myers Squibb | May 3, 2017 |
NCT01716806 | Recruiting | Hodgkin Disease | Seattle Genetics, Inc. | October 30, 2012 |
NCT02744612 | Recruiting | Recurrent Hodgkin Lymphoma, Refractory Hodgkin Lymphoma | City of Hope Medical Center | April 20, 2016 |
NCT01703949 | Recruiting | CD30-Positive Neoplastic Cells Present, Recurrent Hodgkin Lymphoma, Recurrent Non-Hodgkin Lymphoma, Refractory Hodgkin Lymphoma, Refractory Non-Hodgkin Lymphoma | University of Washington | October 11, 2012 |
NCT03264131 | Recruiting | Lymphoma, Adult T-Cell Leukemia/Lymphoma, Lymphatic Diseases | UNC Lineberger Comprehensive Cancer Center | August 28, 2017 |
NCT02280993 | Active, not recruiting | Hodgkin Lymphoma, Refractory, Relapse | Marjolein Spiering | November 3, 2014 |
NCT02822586 | Active, not recruiting | Mycosis Fungoides, Sézary Syndrome | Virginia Commonwealth University | July 4, 2016 |
NCT03013933 | Recruiting | Recurrent Hodgkin Lymphoma, Refractory Hodgkin Lymphoma, CD30-Positive Neoplastic Cells Present | City of Hope Medical Center | January 9, 2017 |
NCT01771107 | Active, not recruiting | AIDS-Related Hodgkin Lymphoma, Ann Arbor Hodgkin Lymphoma, Classic Hodgkin Lymphoma, HIV Infection | National Cancer Institute (NCI) | January 18, 2013 |
NCT02686346 | Active, not recruiting | Hodgkin Disease | The Lymphoma Academic Research Organisation | February 19, 2016 |
NCT02298283 | Active, not recruiting | Hodgkin Lymphoma | The Lymphoma Academic Research Organisation | November 21, 2014 |
NCT01777152 | Active, not recruiting | Anaplastic Large-Cell Lymphoma, Non-Hodgkin Lymphoma, T-Cell Lymphoma | Seattle Genetics, Inc. | January 28, 2013 |
NCT02227199 | Recruiting | Recurrent Adult Hodgkin Lymphoma, Refractory Hodgkin Lymphoma, TNFRSF8 Positive | University of Washington | August 28, 2014 |
NCT01896999 | Recruiting | Recurrent Classic Hodgkin Lymphoma, Refractory Classic Hodgkin Lymphoma | National Cancer Institute (NCI) | July 11, 2013 |
NCT02927769 | Recruiting | Hodgkin Disease | Bristol-Myers Squibb | October 7, 2016 |
NCT03712202 | Recruiting | Ann Arbor Hodgkin Lymphoma, Classic Hodgkin Lymphoma, Lymphocyte-Rich Classic Hodgkin Lymphoma | City of Hope Medical Center | October 19, 2018 |
NCT02191930 | Recruiting | Hodgkin Lymphoma | University of Cologne | July 16, 2014 |
NCT03440788 | Not yet recruiting | Relapsed or Refractory Hodgkin's Lymphoma | Multinational Center for Quality of Life Research, Russia | February 21, 2018 |
NCT01994850 | Active, not recruiting | CD30 Positive Primary Mediastinal Large B-cell Lymphoma, CD30 Positive Diffuse Large B-cell Lymphoma or CD30 Positive Grey Zone Lymphoma | Abramson Cancer Center of the University of Pennsylvania | November 26, 2013 |
NCT02734771 | Recruiting | Diffuse Large B-Cell Lymphoma | Patrick Reagan | April 12, 2016 |
NCT03646123 | Recruiting | Hodgkin Lymphoma | Seattle Genetics, Inc. | August 24, 2018 |
NCT01476410 | Active, not recruiting | Adult Lymphocyte Depletion Hodgkin Lymphoma, Adult Lymphocyte Predominant Hodgkin Lymphoma, Adult Mixed Cellularity Hodgkin Lymphoma, Adult Nodular Sclerosis Hodgkin Lymphoma, Stage II Adult Hodgkin Lymphoma, Stage III Adult Hodgkin Lymphoma, Stage IV Adult Hodgkin Lymphoma | Northwestern University | November 22, 2011 |
NCT03217643 | Recruiting | Enteropathy Associated T-cell Lymphoma | Imagine Institute | July 14, 2017 |
NCT03113500 | Recruiting | Adult T-Cell Leukemia/Lymphoma, Anaplastic Large Cell Lymphoma, ALK-Negative, Anaplastic Large Cell Lymphoma, ALK-Positive, Angioimmunoblastic T-Cell Lymphoma, CD30-Positive Neoplastic Cells Present, Enteropathy-Associated T-Cell Lymphoma, Hepatosplenic T-Cell Lymphoma, Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma, Peripheral T-Cell Lymphoma, Not Otherwise Specified, Stage III Anaplastic Large Cell Lymphoma, Stage IV Anaplastic Large Cell Lymphoma | City of Hope Medical Center | April 13, 2017 |
NCT03233347 | Recruiting | Ann Arbor Stage I Hodgkin Lymphoma, Ann Arbor Stage IA Hodgkin Lymphoma, Ann Arbor Stage IB Hodgkin Lymphoma, Ann Arbor Stage II Hodgkin Lymphoma, Ann Arbor Stage IIA Hodgkin Lymphoma, Ann Arbor Stage IIB Hodgkin Lymphoma | Academic and Community Cancer Research United | July 28, 2017 |
NCT02166463 | Recruiting | Ann Arbor Stage IIB Hodgkin Lymphoma, Ann Arbor Stage IIIB Hodgkin Lymphoma, Ann Arbor Stage IV Hodgkin Lymphoma, Ann Arbor Stage IVA Hodgkin Lymphoma, Ann Arbor Stage IVB Hodgkin Lymphoma, Childhood Hodgkin Lymphoma, Classic Hodgkin Lymphoma | National Cancer Institute (NCI) | June 18, 2014 |
NCT02292979 | Active, not recruiting | Hodgkin Lymphoma | The Lymphoma Academic Research Organisation | November 18, 2014 |
NCT02243436 | Active, not recruiting | CLASSICAL HODGKIN LYMPHOMA | Grupo Español de Linfomas y Transplante Autólogo de Médula Ósea | September 18, 2014 |
NCT01920932 | Active, not recruiting | Stage II Childhood Hodgkin Lymphoma, Stage III Childhood Hodgkin Lymphoma, Stage IV Childhood Hodgkin Lymphoma | St. Jude Children's Research Hospital | August 12, 2013 |
NCT03246750 | Not yet recruiting | Extranodal NK/T-cell Lymphoma | The Thai Lymphoma Study Group | August 11, 2017 |
NCT01868451 | Recruiting | Hodgkin Lymphoma | Memorial Sloan Kettering Cancer Center | June 4, 2013 |
NCT03540849 | Recruiting | Hodgkin Lymphoma | University Hospital, Caen | May 30, 2018 |
NCT03576378 | Active, not recruiting | Hodgkin Lymphoma | Grupo Español de Linfomas y Transplante Autólogo de Médula Ósea | July 3, 2018 |
NCT03527628 | Recruiting | Classical Hodgkin Lymphoma, Hodgkin Lymphoma (Category), Hodgkin Disease, Hodgkin Lymphoma | King Abdullah International Medical Research Center | May 17, 2018 |
NCT02098512 | Recruiting | Hodgkin Lymphoma | New York Medical College | March 28, 2014 |
NCT01712490 | Active, not recruiting | Hodgkin Lymphoma | Millennium Pharmaceuticals, Inc. | October 23, 2012 |
NCT02398240 | Recruiting | Hodgkin Lymphoma | Mitchell Cairo | March 25, 2015 |
NCT03517137 | Not yet recruiting | Advanced Hodgkin Lymphoma | European Organisation for Research and Treatment of Cancer - EORTC | May 7, 2018 |
NCT03719105 | Recruiting | NK-Cell Lymphoma, NK-Cell Leukemia, Peripheral T Cell Lymphoma | New York Medical College | October 25, 2018 |
NCT03755804 | Recruiting | Hodgkin Lymphoma | St. Jude Children's Research Hospital | November 28, 2018 |
NCT02453594 | Active, not recruiting | Hodgkin Lymphoma | Merck Sharp & Dohme Corp. | May 25, 2015 |
NCT02661503 | Recruiting | Classical Hodgkin Lymphoma | University of Cologne | January 22, 2016 |
NCT03703050 | Recruiting | Relapsing/Refractory ALK+ Anaplastic Large Cell Lymphoma | Gustave Roussy, Cancer Campus, Grand Paris | October 11, 2018 |
NCT03049449 | Recruiting | Lymphoma, Large-Cell, Anaplasitc, Hodgkin Disease, Lymphoma, Hodgkins, Enteropathy-Associated T-Cell Lymphoma, Lymphoma, Extranodal NK-T-Cell | National Cancer Institute (NCI) | February 10, 2017 |
NCT03766516 | Recruiting | Relapsed or Refractory Anaplastic Large Cell Lymphoma & Hodgkin Lymphoma | Samsung Medical Center | December 6, 2018 |
NCT01476839 | Recruiting | Recurrent Adult Hodgkin Lymphoma | City of Hope Medical Center | November 22, 2011 |
Table 2. Approved Drugs of Brentuximab vedotin**
INN (trade name) | Therapeutic area | Dose | Strength | Route | Company | Marketing start | Market |
Adcetris | Hodgkin Lymphoma, Systemic Anaplastic Large Cell Lymphoma | Concentrate for injection | 50MG / vial | Intravenous infusion | Seattle Genetics, Inc. | August 19, 2011 | |
Adcetris | Lymphoma, Non-Hodgkin; Hodgkin Disease | Concentrate for injection | 50MG / vial | Intravenous infusion | Takeda Pharma A/S | October 25, 2012 |
We provide high-quality Brentuximab Vedotin for use in WB, FC, IP, ELISA, Neut, FuncS, IF and most other immunological methods. For lab research use only, not for diagnostic, therapeutic or any in vivo human use.
Reference
*The table was excerpted from the following website
https://clinicaltrials.gov/ct2/results?cond=&term=Brentuximab+vedotin
**Information presented in the table were collected from the following website:
https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=125388
For research use only. Not intended for any clinical use.
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