Brentuximab Vedotin (Adcetris®)
Pronounced: bren-TUX-i-mab ve-DOE-tin
Classification: Antibody-drug conjugate (targeted therapy)
About Brentuximab Vedotin (Adcetris®)
Brentuximab vedotin is an antibody conjugate (an antibody with a cell-killing medication attached to it) directed against a protein called CD30, found on the surface of some lymphoma cells. Antibodies, which are normally found in the body, are developed by the immune system to destroy foreign material (such as a germ). Brentuximab vedotin is a manmade antibody that causes the immune system to attack lymphoma cells that have the CD30 protein on them. In addition, the drug has an agent attached to it that disrupts functions critical to cell growth and, in turn, causes cell death.
How to Take Brentuximab Vedotin
Brentuximab vedotin is given by intravenous (into a vein) infusion. The treatment is delivered over 30 minutes and is typically given every 3 weeks. The dosage depends on the person’s size and type of cancer being treated.
The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. These include: ketoconazole and rifampin. Be sure to tell your healthcare provider about all medications and supplements you take.
Possible Side Effects
There are a number of things you can do to manage the side effects of brentuximab vedotin. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
Peripheral Neuropathy (Numbness or Tingling in the Hands and/or Feet)
Peripheral neuropathy is a toxicity that affects the nerves. It causes a numbness or tingling feeling in the hands and feet, often in the pattern of a stocking or glove. This can get progressively worse with additional doses of the medication. In some people, the symptoms slowly resolve after the medication is stopped, but for some it never goes away completely. You should let your healthcare provider know if you experience numbness or tingling in the hands and feet, as they may need to adjust the doses of your medication.
In some cases, patients can have an allergic reaction to this medication. Signs of a reaction can include: shortness of breath or difficulty breathing, chest pain, rash, flushing or itching, or a decrease in blood pressure. If you notice any changes in how you feel during the infusion, let your nurse know immediately. The infusion will be slowed or stopped if this occurs. Depending on the severity of your reaction, you may still be able to receive the medication with a pre-medication to prevent a reaction, or if the medication is given at a slower rate.
Low White Blood Cell Count (Leukopenia or Neutropenia)
White blood cells (WBC) are important for fighting infection. While receiving treatment, your WBC count can drop, putting you at a higher risk of getting an infection. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.
Tips to preventing infection:
- Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.
- Avoid large crowds and people who are sick (i.e.: those who have a cold, fever or cough or live with someone with these symptoms).
- When working in your yard, wear protective clothing including long pants and gloves.
- Do not handle pet waste.
- Keep all cuts or scratches clean.
- Shower or bath daily and perform frequent mouth care.
- Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
- Ask your doctor or nurse before scheduling dental appointments or procedures.
- Ask your doctor or nurse before you, or someone you live with, has any vaccinations.
This medication can cause liver toxicity, which your doctor may monitor for using blood tests called liver function tests. If you develop elevations in your liver function tests, your healthcare provider may need to lower your dose or stop the medication. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown or pain in your abdomen, as these can be signs of liver toxicity.
Progressive Multifocal Leukoencephalopathy (PML) is a rare, but very serious brain infection that has been reported with this medication. The signs of PML may develop over several weeks or months. They may include changes in mood or usual behavior, confusion, thinking problems, loss of memory, changes in vision, speech, or walking, and decreased strength or weakness on one side of the body. If you, or anyone close to you, notices you have developed any of these signs, notify your healthcare provider immediately.
This medication may cause worsening lung problems. Notify your healthcare team if you develop any new or worsening cough or shortness of breath.
Stevens Johnson Syndrome
Stevens Johnson Syndrome is a rare, but serious, allergic reaction that affects the skin and mucous membranes. It typically starts as a rash or painful blisters and can progress to serious damage to the skin and in some cases, death. It is important that you report any rash to your healthcare providers immediately.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication.