Brentuximab vedotin
ADCs
Antibody-drug conjugates (ADCs)High alert
An error with this medicine can cause serious harm: double checks and protocols are used.
Anti-CD30 antibody carrying the microtubule poison MMAE; used in Hodgkin and anaplastic large cell lymphoma. Watch for neuropathy and PML.
Quick facts
- Group
- Antibody-drug conjugates (ADCs)
- Target
- CD30 (TNFRSF8) on lymphoma cells
- Used for
- Classic Hodgkin lymphoma
- Key effects
- Peripheral sensory neuropathy · Neutropenia · Fatigue
- Monitor
- Neurological symptoms · Neuropathy at each visit
- ATC
- L01FX05
No doses: the clinician sets them by the current guideline.
Mechanism of action
The chimeric IgG1 antibody binds CD30, which is abundant on Hodgkin Reed-Sternberg cells and anaplastic large cell lymphoma. After internalisation, proteases cleave the linker and release monomethyl auristatin E (MMAE), which disrupts the microtubule network, arrests the cell cycle and causes apoptosis.
- The antibody binds CD30 on the lymphoma cell
- The conjugate is internalised
- Proteases release MMAE inside the cell
- Microtubules break down: arrest and apoptosis
Indications
- Classic Hodgkin lymphoma: untreated advanced disease with chemotherapy, high risk of relapse after autologous transplant, or relapse after transplant or several regimens. Hodgkin lymphoma →
- Systemic anaplastic large cell lymphoma and other CD30-positive peripheral T-cell lymphomas; some relapsed large B-cell lymphomas in combination. Non-Hodgkin lymphoma →
- Primary cutaneous anaplastic large cell lymphoma and CD30-positive mycosis fungoides after prior systemic therapy. Mycosis fungoides and Sézary syndrome (cutaneous T-cell lymphoma) →
Adverse effects
Common
- Peripheral sensory neuropathy (numbness, tingling)
- Neutropenia, anaemia, thrombocytopenia
- Fatigue, nausea, diarrhoea, vomiting
- Fever, rash, cough
- Upper respiratory infections
Contraindications
- Allergy to the drug
- Caution in pre-existing neuropathy, liver or kidney disease and immunosuppression
Key interactions
- Strong CYP3A4 inhibitors (e.g. ketoconazole)
- Raise MMAE exposure and its toxicity (neutropenia, neuropathy).
- Strong CYP3A4 inducers (e.g. rifampicin)
- Lower MMAE exposure.
What is monitored
- Neurological symptoms: new weakness on one side, confusion, speech or vision changes (PML)
- Neuropathy at each visit
- Complete blood count before each dose
- Liver tests and blood glucose
- Infusion reactions
Administration and safety
- Intravenous infusion, never as a push or bolus; given in a clinic or hospital.
- Hazardous drug: prepared and handled with chemotherapy precautions.
- Watch for infusion reactions during and in the day after the dose.
Pregnancy and breastfeeding
Can harm the fetus; a pregnancy test is done and effective contraception is used during and after treatment, and breastfeeding is not advised.
Nursing care
- Ask about numbness, tingling, burning or weakness in the limbs at every visit; report new symptoms before the dose.
- Report at once any new neurological deficit, confusion, clumsiness or vision change (PML).
- Review blood counts and watch for fever.
- Teaching: report fever, cough, severe abdominal pain or yellow skin; use effective contraception.
Pharmacokinetics
- Absorption
- Intravenous infusion.
- Metabolism
- The released MMAE is metabolised mainly by CYP3A4.
Test yourself
Think of the answer, then tap the question to see it.
Which antigen does brentuximab vedotin target?
CD30, abundant on Hodgkin Reed-Sternberg cells and anaplastic large cell lymphoma.
What is the boxed warning of brentuximab vedotin?
Progressive multifocal leukoencephalopathy (PML).
What is the most common dose-limiting effect of brentuximab vedotin?
Peripheral sensory neuropathy, from the MMAE payload.
Why does ketoconazole matter with brentuximab vedotin?
It inhibits CYP3A4 and raises exposure to the MMAE payload.
Connections
← Back to the class: Antibody-drug conjugates (ADCs)
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Brentuximab Vedotin Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Brentuximab Vedotin - NCI (National Cancer Institute, 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.