{"entity":{"id":"brentuximab-vedotin","kind":"drug","name":"Brentuximab vedotin","aka":[],"tldr":"The ADC that made the modern field credible (2011), for Hodgkin lymphoma and CD30+ lymphomas.","summary":"Brentuximab vedotin is a chimeric anti-CD30 IgG1 antibody carrying the microtubule poison MMAE (drug-to-antibody ratio about 4) through a cleavable mc-vc-PABC linker; inside a CD30-positive cell MMAE blocks mitosis and diffuses to kill neighbouring cells. Approved in 2011 for relapsed Hodgkin lymphoma and systemic anaplastic large-cell lymphoma, it made the modern ADC field credible and later moved to first line with AVD (ECHELON-1, overall survival benefit), CD30-positive peripheral T-cell lymphoma with CHP (ECHELON-2), post-transplant consolidation (AETHERA) and paediatric Hodgkin lymphoma. Peripheral neuropathy affected 65 percent of the A+AVD arm in ECHELON-1 and neutropenia 91 percent, so G-CSF prophylaxis is mandatory and bleomycin is contraindicated. Its vc-MMAE linker-payload was reused in enfortumab, polatuzumab, tisotumab and disitamab vedotin.","status":"approved","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Brentuximab_vedotin","links":[{"label":"FDA label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Brentuximab%20vedotin"},{"label":"Kuppers, Nat Rev Cancer 2009: the biology of Hodgkin's lymphoma","url":"https://doi.org/10.1038/nrc2542"}],"tags":[],"related":["cd30-expression"],"cancers":["hodgkin-lymphoma","cutaneous-t-cell-lymphoma","advanced-stage-classical-hodgkin-lymphoma","relapsed-refractory-hodgkin-lymphoma"],"sections":[],"technologies":["adc"],"targets":[],"drugs":[],"companies":["pfizer","takeda"],"institutions":[],"pathways":[],"terms":["mc-vc-pabc"],"trials":["nct04404283","nct02979522","nct05673785"],"people":[],"bottlenecks":[],"keyPapers":["paper-alcanza-brentuximab-vedotin-lancet-2017"],"journals":[],"dependsOn":[],"notes":["Lymphoma biology: CD30 is as close as lymphoma gets to an antigen restricted to the tumour in an adult, because resting lymphocytes do not carry it. That is why this conjugate does not produce the compartment-emptying effects of the anti-B-cell agents and why its limiting toxicity is the auristatin payload. In classical Hodgkin lymphoma the antigen is on essentially every Reed-Sternberg cell even though those cells are a small minority of the tissue (Kuppers 2009)."],"brand":"Adcetris","modality":"ADC","payload":"MMAE, DAR ~4","linker":"mc-vc-PABC, cleavable","mechanism":"Chimeric anti-CD30 IgG1 with MMAE.","approvals":[{"region":"US","year":2011,"indication":"Relapsed Hodgkin lymphoma and systemic ALCL"},{"region":"US","year":2018,"indication":"First-line stage III/IV Hodgkin lymphoma with AVD"}],"mechanismSteps":["Antibody binds CD30 on the tumour cell surface","Receptor-ADC complex is internalised by endocytosis","Trafficked to the lysosome; linker is cleaved or antibody degraded","MMAE is released inside the cell","Microtubule assembly is blocked; mitosis arrests","Tumour cell dies by apoptosis","Membrane-permeable payload diffuses to kill neighbouring antigen-negative cells (bystander effect)"],"dosing":{"route":"IV infusion","schedule":"1.8 mg/kg (max 180 mg) every 3 weeks; 1.2 mg/kg (max 120 mg) every 2 weeks with AVD","modifications":"G-CSF prophylaxis mandatory with AVD; hold for grade 2 neuropathy; contraindicated with bleomycin","monitoring":"Neuropathy, blood counts, PML symptoms, LFTs","source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3904f8dd-1aef-3490-e48f-bd55f32ed67f"},"toxicity":[{"event":"Neutropenia","anyGradePct":91,"grade3PlusPct":82,"source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3904f8dd-1aef-3490-e48f-bd55f32ed67f","note":"ECHELON-1, A+AVD arm"},{"event":"Peripheral sensory neuropathy","anyGradePct":65,"grade3PlusPct":10,"source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3904f8dd-1aef-3490-e48f-bd55f32ed67f","note":"ECHELON-1, A+AVD arm"},{"event":"Constipation","anyGradePct":42,"grade3PlusPct":2,"source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3904f8dd-1aef-3490-e48f-bd55f32ed67f","note":"ECHELON-1, A+AVD arm"},{"event":"Nausea","anyGradePct":40,"grade3PlusPct":2,"source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3904f8dd-1aef-3490-e48f-bd55f32ed67f","note":"ECHELON-1, A+AVD arm"},{"event":"Vomiting","anyGradePct":33,"grade3PlusPct":3,"source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3904f8dd-1aef-3490-e48f-bd55f32ed67f","note":"ECHELON-1, A+AVD arm"},{"event":"Febrile neutropenia","anyGradePct":19,"grade3PlusPct":19,"source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3904f8dd-1aef-3490-e48f-bd55f32ed67f","note":"ECHELON-1, A+AVD arm"}],"access":[{"country":"US","reimbursement":"Medicare Part B (physician-administered); commercial plans per formulary","source":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","asOf":"2026-09-06"},{"country":"UK","reimbursement":"NICE: recommended in CD30+ Hodgkin lymphoma settings (TA446, TA524) and first-line stage IV with AVD","source":"https://www.nice.org.uk/guidance/published?ngt=Technology%20appraisal%20guidance","asOf":"2026-09-06"}],"regulatoryEvents":[{"date":"2011-08-19","type":"accelerated-approval","region":"US","note":"Accelerated approval, relapsed Hodgkin lymphoma and systemic ALCL","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications","indication":"Hodgkin lymphoma after failure of autologous stem cell transplant (ASCT), or after failure of at least 2 multi-agent chemotherapy regimens in patients who are not ASCT candidates"},{"date":"2011-08-19","type":"accelerated-approval","region":"US","note":"Accelerated approval on a surrogate endpoint, with a confirmatory trial required.","indication":"Systemic anaplastic large cell lymphoma after failure of at least one multi-agent chemotherapy regimen"},{"date":"2015-08-17","type":"conversion","region":"US","note":"Post-transplant consolidation in Hodgkin lymphoma (AETHERA)","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications","indication":"Hodgkin lymphoma after failure of autologous stem cell transplant (ASCT), or after failure of at least 2 multi-agent chemotherapy regimens in patients who are not ASCT candidates"},{"date":"2018-03-20","type":"conversion","region":"US","note":"First-line stage III/IV Hodgkin lymphoma with AVD (ECHELON-1)","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications","indication":"Systemic anaplastic large cell lymphoma after failure of at least one multi-agent chemotherapy regimen"},{"date":"2018-11-16","type":"approval","region":"US","note":"First-line CD30+ peripheral T-cell lymphoma with CHP (ECHELON-2)","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications"},{"date":"2022-11-10","type":"approval","region":"US","note":"Paediatric high-risk Hodgkin lymphoma","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications"}]},"route":"/drugs/brentuximab-vedotin/","neighbours":{"biomarker":[{"id":"cd30-expression","kind":"biomarker","name":"CD30 expression (CD30-positive)","route":"/biomarkers/cd30-expression/"}],"cancer":[{"id":"advanced-stage-classical-hodgkin-lymphoma","kind":"cancer","name":"Advanced-stage classical Hodgkin lymphoma (stage III to IV)","route":"/cancers/advanced-stage-classical-hodgkin-lymphoma/"},{"id":"alk-negative-anaplastic-large-cell-lymphoma","kind":"cancer","name":"ALK-negative anaplastic large cell lymphoma","route":"/cancers/alk-negative-anaplastic-large-cell-lymphoma/"},{"id":"alk-positive-anaplastic-large-cell-lymphoma","kind":"cancer","name":"ALK-positive anaplastic large cell lymphoma","route":"/cancers/alk-positive-anaplastic-large-cell-lymphoma/"},{"id":"breast-implant-associated-alcl","kind":"cancer","name":"Breast implant-associated anaplastic large cell lymphoma","route":"/cancers/breast-implant-associated-alcl/"},{"id":"cutaneous-t-cell-lymphoma","kind":"cancer","name":"Cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome)","route":"/cancers/cutaneous-t-cell-lymphoma/"},{"id":"early-stage-classical-hodgkin-lymphoma","kind":"cancer","name":"Early-stage classical Hodgkin lymphoma (stage I to II)","route":"/cancers/early-stage-classical-hodgkin-lymphoma/"},{"id":"hiv-associated-lymphoma","kind":"cancer","name":"HIV-associated (AIDS-related) lymphomas","route":"/cancers/hiv-associated-lymphoma/"},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/"},{"id":"mycosis-fungoides","kind":"cancer","name":"Mycosis fungoides","route":"/cancers/mycosis-fungoides/"},{"id":"angioimmunoblastic-t-cell-lymphoma","kind":"cancer","name":"Nodal T-follicular helper cell lymphoma, angioimmunoblastic type (angioimmunoblastic T-cell lymphoma)","route":"/cancers/angioimmunoblastic-t-cell-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"peripheral-t-cell-lymphoma","kind":"cancer","name":"Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)","route":"/cancers/peripheral-t-cell-lymphoma/"},{"id":"primary-cutaneous-anaplastic-large-cell-lymphoma","kind":"cancer","name":"Primary cutaneous anaplastic large cell lymphoma","route":"/cancers/primary-cutaneous-anaplastic-large-cell-lymphoma/"},{"id":"primary-mediastinal-b-cell-lymphoma","kind":"cancer","name":"Primary mediastinal (thymic) large B-cell lymphoma","route":"/cancers/primary-mediastinal-b-cell-lymphoma/"},{"id":"relapsed-refractory-hodgkin-lymphoma","kind":"cancer","name":"Relapsed and refractory classical Hodgkin lymphoma","route":"/cancers/relapsed-refractory-hodgkin-lymphoma/"},{"id":"sezary-syndrome","kind":"cancer","name":"Sezary syndrome","route":"/cancers/sezary-syndrome/"}],"technology":[{"id":"adc","kind":"technology","name":"Antibody-drug conjugate (ADC)","route":"/technologies/adc/"},{"id":"adc-supply-chain","kind":"technology","name":"The ADC supply chain (antibody, payload-linker, conjugation, fill)","route":"/technologies/adc-supply-chain/"}],"company":[{"id":"ghsg","kind":"company","name":"German Hodgkin Study Group","route":"/companies/ghsg/"},{"id":"pfizer","kind":"company","name":"Pfizer (incl. Seagen)","route":"/companies/pfizer/"},{"id":"takeda","kind":"company","name":"Takeda","route":"/companies/takeda/"}],"term":[{"id":"abvd-beacopp","kind":"term","name":"ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens)","route":"/terms/abvd-beacopp/"},{"id":"lymphoma-b-versus-t-cell","kind":"term","name":"B-cell, T-cell and NK-cell lymphoma","route":"/terms/lymphoma-b-versus-t-cell/"},{"id":"lymphoma-tx-uk-versus-us","kind":"term","name":"British and American lymphoma practice: where they differ, and why","route":"/terms/lymphoma-tx-uk-versus-us/"},{"id":"lymphoma-type","kind":"term","name":"Lymphoma (tissue type)","route":"/terms/lymphoma-type/"},{"id":"lymphoma-tx-maintenance","kind":"term","name":"Maintenance and consolidation in lymphoma: where it works and where it does not","route":"/terms/lymphoma-tx-maintenance/"},{"id":"mc-vc-pabc","kind":"term","name":"mc-Val-Cit-PABC","route":"/terms/mc-vc-pabc/"},{"id":"mmae","kind":"term","name":"MMAE","route":"/terms/mmae/"},{"id":"peripheral-neuropathy","kind":"term","name":"Peripheral neuropathy (chemotherapy-induced)","route":"/terms/peripheral-neuropathy/"},{"id":"lymphoma-tx-regimen-alphabet","kind":"term","name":"The lymphoma regimen alphabet: R-CHOP, pola-R-CHP, DA-EPOCH-R, ABVD, BEACOPP and the rest","route":"/terms/lymphoma-tx-regimen-alphabet/"},{"id":"tubulin-inhibitor-payloads","kind":"term","name":"Tubulin inhibitor payloads","route":"/terms/tubulin-inhibitor-payloads/"},{"id":"lymphoma-tx-uk-access","kind":"term","name":"What the NHS in England funds for lymphoma, appraisal by appraisal","route":"/terms/lymphoma-tx-uk-access/"}],"trial":[{"id":"nct02979522","kind":"trial","name":"A Study of Brentuximab Vedotin + Adriamycin, Vinblastine, and Dacarbazine in Pediatric Participants With Advanced Stage Newly Diagnosed Hodgkin Lymphoma","route":"/trials/nct02979522/"},{"id":"nct05673785","kind":"trial","name":"A Study of Brentuximab Vedotin in Combination With Cyclophosphamide, Doxorubicin (Hydroxydaunorubicin), Prednisone (CHP) in Chinese Participants With CD30-Positive (CD30+) Peripheral T-Cell Lymphomas (PTCL)","route":"/trials/nct05673785/"},{"id":"aethera","kind":"trial","name":"AETHERA","route":"/trials/aethera/"},{"id":"ahod1331","kind":"trial","name":"AHOD1331","route":"/trials/ahod1331/"},{"id":"ahod2131","kind":"trial","name":"AHOD2131 (COG / NCTN)","route":"/trials/ahod2131/"},{"id":"alcanza","kind":"trial","name":"ALCANZA","route":"/trials/alcanza/"},{"id":"nct04404283","kind":"trial","name":"Brentuximab Vedotin Plus Lenalidomide and Rituximab for the Treatment of Relapsed/Refractory DLBCL","route":"/trials/nct04404283/"},{"id":"echelon-1","kind":"trial","name":"ECHELON-1","route":"/trials/echelon-1/"},{"id":"echelon-2","kind":"trial","name":"ECHELON-2","route":"/trials/echelon-2/"},{"id":"hd21","kind":"trial","name":"GHSG HD21","route":"/trials/hd21/"},{"id":"keynote-204","kind":"trial","name":"KEYNOTE-204","route":"/trials/keynote-204/"},{"id":"radar-hodgkin","kind":"trial","name":"RADAR","route":"/trials/radar-hodgkin/"},{"id":"swog-s1826","kind":"trial","name":"SWOG S1826","route":"/trials/swog-s1826/"}],"paper":[{"id":"paper-aethera-brentuximab-consolidation-after-asct-hodgkin-lancet-2015","kind":"paper","name":"AETHERA: brentuximab vedotin consolidation after autologous stem cell transplantation in Hodgkin lymphoma at risk of relapse","route":"/key-papers/paper-aethera-brentuximab-consolidation-after-asct-hodgkin-lancet-2015/"},{"id":"paper-ahod1331-brentuximab-vedotin-paediatric-hodgkin-castellino-nejm-2022","kind":"paper","name":"AHOD1331: brentuximab 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lymphoma","route":"/key-papers/paper-echelon-1-brentuximab-avd-nejm-2018/"},{"id":"paper-ghsg-hd21-brecadd-vs-ebeacopp-advanced-hodgkin-lancet-2024","kind":"paper","name":"GHSG HD21: PET-guided BrECADD versus escalated BEACOPP in advanced-stage classical Hodgkin lymphoma","route":"/key-papers/paper-ghsg-hd21-brecadd-vs-ebeacopp-advanced-hodgkin-lancet-2024/"},{"id":"paper-keynote-204-pembrolizumab-vs-brentuximab-rr-hodgkin-lancet-oncol-2021","kind":"paper","name":"KEYNOTE-204: pembrolizumab versus brentuximab vedotin in relapsed or refractory classical Hodgkin lymphoma","route":"/key-papers/paper-keynote-204-pembrolizumab-vs-brentuximab-rr-hodgkin-lancet-oncol-2021/"},{"id":"paper-swog-s1826-nivolumab-avd-nejm-2024","kind":"paper","name":"SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults","route":"/key-papers/paper-swog-s1826-nivolumab-avd-nejm-2024/"}],"target":[{"id":"cd30","kind":"target","name":"CD30","route":"/targets/cd30/"}],"pairing":[{"id":"bleomycin-omission-caution","kind":"pairing","name":"Caution: bleomycin lung toxicity, especially with brentuximab or G-CSF","route":"/pairings/bleomycin-omission-caution/"}],"idea":[{"id":"lymphoma-ev-radiotherapy-free-early-hodgkin","kind":"idea","name":"A radiotherapy-free cure for early Hodgkin lymphoma that actually holds","route":"/ideas/lymphoma-ev-radiotherapy-free-early-hodgkin/"},{"id":"idea-chemo-free-hodgkin","kind":"idea","name":"Chemotherapy-free Hodgkin lymphoma: brentuximab + PD-1 in early stage","route":"/ideas/idea-chemo-free-hodgkin/"},{"id":"lymphoma-ev-late-effects-of-the-treatments-given-now","kind":"idea","name":"Measure the late effects of the treatments being given now, not the ones given in 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Herrera","route":"/people/alex-herrera/"},{"id":"joseph-connors","kind":"person","name":"Joseph M. Connors","route":"/people/joseph-connors/"},{"id":"kara-kelly","kind":"person","name":"Kara M. Kelly","route":"/people/kara-kelly/"},{"id":"peter-borchmann","kind":"person","name":"Peter Borchmann","route":"/people/peter-borchmann/"},{"id":"steven-horwitz","kind":"person","name":"Steven M. Horwitz","route":"/people/steven-horwitz/"}],"institution":[{"id":"bc-cancer","kind":"institution","name":"BC Cancer","route":"/institutions/bc-cancer/"}],"pathway":[{"id":"mitotic-spindle-checkpoint","kind":"pathway","name":"Mitosis & the spindle assembly checkpoint","route":"/pathways/mitotic-spindle-checkpoint/"}]}}