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What brentuximab is

Brentuximab (pronounced bren-tuk-see-mab) is a type of monoclonal antibody. It is also known by its full name brentuximab vedotin and its brand name, Adcetris. It is a treatment for Hodgkin lymphoma and a type of non Hodgkin lymphoma called anaplastic large cell lymphoma (ALCL).

Monoclonal antibodies (MABs) are copies of a single antibody. They are made in the laboratory. MABs seek out cancer cells by targeting particular proteins on the cell surface.

Brentuximab targets a protein called CD 30. CD30 is found on Hodgkin lymphoma and APLC lymphoma cells. Brentuximab sticks to the CD30 protein and delivers a drug to the cell. The drug then kills the cell.

 

How you have brentuximab

You have brentuximab through a drip into a vein (infusion), through a small tube called a cannula. You have the treatment over 30 minutes. You have it once every 3 weeks up to 16 times, for as long as it is working. So the course of treatment takes up to 48 weeks (almost one year).

 

About side effects

We've listed the side effects associated with brentuximab below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.

You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)

The side effects may be different if you are having brentuximab with other drugs.

Tell your doctor or nurse straight away if any of the side effects get severe.

 

Common side effects

More than 10 out of 100 people have one or more of the following effects.

  • Numbness or tingling in fingers and toes happens in 4 out of every 10 people (40%) – it can cause difficulty with fiddly things such as doing up buttons. It starts within a few days or weeks and usually goes within a few months of finishing treatment
  • Feeling or being sick happens in about 4 out of every 10 people (40%) but is usually well controlled with anti sickness medicines
  • Tiredness (fatigue) affects 4 out of 10 people (40%) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
  • Diarrhoea happens in 3 out of 10 people (30%) – drink plenty of fluids and tell your doctor or nurse if it becomes severe or continues for more than 3 days
  • A high temperature (fever)
  • A skin reaction happens in 1 out of 4 people (25%) – you may have a rash similar to acne on your face, neck and trunk or your skin may be dry and itchy
  • Constipation happens in just under 2 out of 10 people (20%) – your doctor or nurse may give you laxatives to help prevent this but do tell them if you are constipated for more than 3 days
  • An increased risk of getting an infection due to a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. This can be life threatening. Contact your doctor or specialist nurse straight away if you think you have an infection. Your doctor will check your white blood cell levels regularly
  • An allergic reaction may happen while you have the treatment (or in the evening after your treatment), causing a high temperature (fever), chills, shivering (rigors), a headache and feeling sick. Some people have a more severe reaction, with wheezing, an itchy rash and a drop in blood pressure. Your nurse will give you medicines before treatment to try to prevent a reaction. They will stop or slow your drip if you have a reaction
  • Headaches
  • Muscle pain
  • Aching joints
  • Loss of appetite happens in just over 1 in 10 people (10%)
  • Loss of fertility – we don’t know exactly how this drug affects fertility so do talk to your doctor before starting treatment if you think you will want to have a baby in the future
 

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these effects.

  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs
  • Liver changes that are mild and  unlikely to cause symptoms – they will almost certainly go back to normal when treatment is finished. You will have regular blood tests to check how well your liver is working
  • Hair thinning
  • High blood sugar levels
  • Dizziness
  • A cough and breathlessness
  • Chills
  • Severe infection leading to a high temperature, a quick pulse, fast breathing and confusion – this can be life threatening. You should tell your doctor or nurse straight away if you have these signs
 

Rare side effects

Fewer than 1 in 100 people have these effects.

  • A severe skin reaction called Stevens-Johnson syndrome
  • High uric acid levels in the blood due to the breakdown of cancer cells (tumour lysis syndrome) – you will have regular blood tests to check your uric acid levels and may have a tablet called allopurinol to take. Drinking plenty of fluids helps to flush out the excess uric acid
  • A viral infection that damages areas of brain tissue – it can cause confusion, difficulty thinking, memory loss, eyesight changes, weakness, loss of control or sensation in an arm or leg, difficulty walking, or loss of balance. This condition can be very serious and even life threatening. Let your doctor or nurse know straight away if you have any of these changes. Your family or carers should also look out for them. The changes are called progressive multifocal leukoencephalopathy (PML)
 

Important points to remember

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child. You need to use 2 effective methods of contraception during treatment and for 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Do not breastfeed during this treatment because the drug may come through in the breast milk.

 

Immunisations

You should not have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.

 

More information about brentuximab

This information does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk/emc.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 15 April 2013