Brentuximab vedotin in anaplastic large cell lymphoma

Brentuximab vedotin , a novel anti-CD30 antibody-drug conjugate, delivers a cytotoxic agent into CD30(+) cells. CD30 expression is characteristic of anaplastic large cell lymphoma (ALCL) and Hodgkin lymphoma (HL).

We reviewed data on brentuximab vedotin, focusing on ALCL and discuss pharmacology, clinical trials leading to approval and future research directions. Systemic ALCL, 3% of adult NHL, is characterized by large anaplastic CD30(+) cells. The fusion protein NPM-ALK, when present in systemic ALCL, confers better prognosis, although even ALK- patients with IPI score ≥ 3 are high-risk. For patients with systemic ALCL, 25 - 45% relapse after frontline therapy, and > 50% of patients will relapse following high-dose chemotherapy with autologous stem-cell support. There has been no standard therapy for relapsed/refractory systemic ALCL. Brentuximab vedotin, combines a monoclonal antibody targeted to CD30 with a microtubule disrupting agent and was recently approved for treatment of patients with systemic ALCL that is refractory or relapsed after at least one multiagent chemotherapy regimen.

Brentuximab vedotin provides targeted therapy to CD30(+) lymphomas, including ALCL and HL, with high response rates and manageable toxicity, predominantly myelosuppression and peripheral neuropathy.