Drug reference
CD30 positive Hodgkin lymphoma (specialist use only) | Systemic anaplastic large cell lymphoma (specialist use only) | CD30 positive cutaneous T-cell lymphoma (specialist use only) ▶BY INTRAVENOUS INFUSION ▶Adult: (consult product literature)
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Elevated BMI—risk of hyperglycaemia. high tumour burden—risk of tumour lysis syndrome. rapidly proliferating tumours—risk of tumour lysis syndrome
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NICE decisions ▶Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma (October 2017) NICE TA478 Brentuximab vedotin is recommended as an option for treating relapsed or refractory systemic anaplastic large cell lymphoma in adults, only if: . they have an Eastern Cooperative Oncology Group performance status of 0 or 1, and . the manufacturer provides brentuximab vedotin according to the commercial access agreement with NHS England. These recommendations are not intended to affect treatment that was started in the NHS before this guidance was published. Adults having treatment outside these recommendations may continue without change to the funding arrangements in place before this guidance was published, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta478 ▶Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma (June 2018) NICE TA524 Brentuximab vedotin is recommended as an option for treating CD30-positive Hodgkin lymphoma in adults with relapsed or refractory disease, only if: . they have already had autologous stem cell transplant, or . they have already had at least 2 previous therapies when autologous stem cell transplant or multi-agent chemotherapy are not suitable, and . the manufacturer provides brentuximab vedotin according to the commercial arrangement. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta524 ▶Brentuximab vedotin for treating CD30-positive cutaneous T- cell lymphoma (April 2019) NICE TA577 Brentuximab vedotin (Adcetris ®) is recommended as an option for treating CD30-positive cutaneous T-cell lymphoma (CTCL) after at least one systemic therapy in adults, only if: . they have mycosis fungoides stage IIB or over, primary cutaneous anaplastic large cell lymphoma or Sézary syndrome, and . the manufacturer provides brentuximab vedotin according to the commercial arrangement. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta577 Scottish Medicines Consortium (SMC) decisions SMC No. SMC2229 The Scottish Medicines Consortium has advised (January 2020) that brentuximab vedotin (Adcetris ®) is accepted for restricted use within NHS Scotland for the treatment of adults with advanced CD30-positive cutaneous T-cell lymphoma defined as mycosis fungoides stage IIB and above, primary cutaneous anaplastic large cell lymphoma or Sézary Syndrome, after at least one prior systemic therapy. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower.
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→Appendix 1: monoclonal antibodies
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▶Common or very common Abdominal pain. alopecia. anaemia. arthralgia. back pain. chills. constipation. cough. diarrhoea. dizziness. dyspnoea. fatigue. fever. hyperglycaemia. increased risk of infection. infusion related reaction. myalgia. nausea. nerve disorders. neutropenia. skin reactions. thrombocytopenia. vomiting . weight decreased ▶Uncommon Anaphylactic reaction. cytomegalovirus infection reactivation. pancreatitis acute. sepsis. severe cutaneous adverse reactions (SCARs). tumour lysis syndrome ▶Frequency not known Disease recurrence. gastrointestinal disorders. gastrointestinal haemorrhage. progressive multifocal leukoencephalopathy (PML). respiratory disorders
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Effective contraception required during treatment and for 6 months after treatment in men and women.
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Avoid unless potential benefit outweighs risk (toxicity in animal studies).
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Avoid—no information available.
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▶Monitor for symptoms of progressive multifocal leucoencephalopathy (presenting as new or worsening neurological, cognitive or behavioural signs or symptoms). ▶Monitor for new or worsening abdominal pain— investigate and withhold treatment if acute pancreatitis suspected and discontinue if confirmed (fatal cases reported). ▶Monitor for pulmonary toxicity—treat symptoms promptly. ▶Routinely monitor hepatic function. ▶Monitor for infusion-related (including anaphylactic) reactions. ▶Monitor for signs of peripheral neuropathy—consult product literature for treatment adjustment.
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There can be variation in the licensing of different medicines containing the same drug. Powder for solution for infusion EXCIPIENTS: May contain Polysorbates ELECTROLYTES: May contain Sodium ▶Adcetris (Takeda UK Ltd) A Brentuximab vedotin 50 mg Adcetris 50mg powder for concentrate for solution for infusion vials | 1 vial P £2,500.00
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(consult product literature)
First-line fragment. Read the complete Indications and Dose section above.
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