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Drug · ADC · Anti-CD30

Brentuximab vedotin

Trade name: Adcetris.

Brentuximab vedotin is an antibody-drug conjugate of an anti-CD30 monoclonal antibody linked to monomethyl auristatin E (MMAE), a microtubule-disrupting cytotoxic. CD30 is variably expressed on mycosis fungoides cells (typically >10% positive cells correlates with response). NICE-approved (TA577) for CD30-positive relapsed or refractory cutaneous T-cell lymphoma. Also used in Hodgkin lymphoma and systemic ALCL.

CurrentLast reviewed 25 March 2026

Indications (UK skin cancer)

  • CD30+ cutaneous T-cell lymphoma (MF or primary cutaneous ALCL) after at least one prior systemic therapy, and CD30-positive (ALCANZA required ≥ 10% positive cells) — NICE TA577 (the ALCANZA population).

Dosing

  • 1.8 mg/kg IV every 3 weeks. Doses are capped at the equivalent of a 100 kg patient (180 mg) per UK SmPC.
  • Up to 16 cycles (CTCL).

Adverse events

  • Peripheral neuropathy (~60%) — sensory predominant; often dose-limiting; may persist after discontinuation.
  • Neutropenia (Grade 3–4 ~10–15%), thrombocytopenia, anaemia.
  • Fatigue, nausea, diarrhoea.
  • Infusion reactions.
  • Progressive multifocal leukoencephalopathy (PML) — rare but fatal JCV reactivation; a boxed warning in the FDA label and an EMA / UK SmPC caution.
  • Pulmonary toxicity / interstitial lung disease — including non-infectious pneumonitis; monitor for new respiratory symptoms. Bleomycin is contraindicated in combination (severe pulmonary toxicity, particularly in Hodgkin lymphoma regimens).
  • Acute pancreatitis — reported, sometimes fatal; monitor amylase / lipase if symptoms.
  • Hepatotoxicity (LFT derangement; severe / fatal cases reported).
  • Hyperglycaemia, particularly in patients with high BMI or pre-existing diabetes.
  • Severe cutaneous reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis (rare).
  • Tumour lysis syndrome in bulky CD30+ disease — consider prophylaxis.

References

  1. Prince HM et al. Brentuximab vedotin or physician's choice in CD30-positive cutaneous T-cell lymphoma (ALCANZA). Lancet; 2017.
  2. NICE TA577. Brentuximab vedotin for treating CD30-positive cutaneous T-cell lymphoma. London: NICE; accessed 18 May 2026.

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