Care During Chemotherapy and Beyond

Brentuximab Vedotin

Brentuximab Vedotin (bren TUX i mab ve Doe tin)

Trade Name: Adcetris®

Brentuximab vedotin is the generic name for the trade name drug Adcetris. In some cases, health care professionals may use the trade name, Adcetris, when referring to the generic drug name, brentuximab vedotin.

Drug Type:

Brentuximab vedotin is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "­­­­­­­­­antineoplastic agent and a monoclonal antibody". (For more detail, see “How Brentuximab Vedotin Works” below)

What Brentuximab Vedotin Is Used For:

  • Treatment of adult patients with previously untreated stage III or IV classical Hodgkin lymphoma (cHL) in combination with chemotherapy.
  • Treatment of patients with Classical Hodgkins Lymphoma (cHL) at high risk of relapse or progression as post autologous hematopoietic stem cell transplantation (auto-HSCT) consolidation.
  • Treatment of patients with cHL after failure of auto-HSCT or after failure of at least two prior multi-agent chemotherapy regimens in patients who are not candidates for auto-HSCT.
  • Treatment of patients with systemic anaplastic large cell lymphoma after failure of at least one prior multi-agent chemotherapy regimen.
  • Treatment of patients with primary cutaneous anaplastic large cell lymphoma (pcALCL) or CD30-expressing mycosis fungoides (MF).

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Brentuximab Vedotin Is Given:

  • As an infusion into a vein (intravenous, IV) over 30 minutes.
  • The amount of brentuximab vedotin that you will receive depends on many factors, including your weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule

Brentuximab Vedotin Side Effects:

Important things to remember about the side effects of brentuximab vedotin:

  • Most people will not experience all of the brentuximab vedotin side effects listed.
  • Brentuximab vedotin side effects are often predictable in terms of their onset, duration, and severity.
  • Brentuximab vedotin side effects will improve after therapy is complete.
  • Brentuximab vedotin side effects may be quite manageable. There are many options to minimize or prevent the side effects of brentuximab vedotin.

The following side effects are common (occurring in greater than 30%) for patients taking brentuximab vedotin:

These are less common (occurring in 10-29%) side effects for patients receiving brentuximab vedotin:

Other very rare (less than 1 %) but serious brentuximab vedotin side effects include:

- Progressive multifocal leukoencephalopathy (PML) (a rare but serious brain infection). The signs and symptoms of PML may develop over the course of several weeks or months. They may include changes in mood or usual behavior, confusion, thinking problems, loss of memory, changes in vision, speech, or walking, and decreased strength or weakness on one side of the body. Patients who develop any signs and symptoms of PML should notify their healthcare professional immediately.

- Stevens-Johnson syndrome (very rare and serious condition in which skin and mucous membranes react to a medication or infection)

- Tumor lysis syndrome (Rapid destruction of cancer cells can cause disturbances in metabolism leading to kidney problems).

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not all listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When To Contact Your Doctor or Health Care Provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4º F (38º C) or higher, chills (possible signs of infection)
  • Chest pain
  • Shortness of breath
  • Confusion in thought processes, eyesight, or balance

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Decreased urination
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)
  • Muscle weakness
  • Mouth sores (painful redness, swelling or ulcers)

Always inform your health care provider if you experience any unusual symptoms.

Brentuximab Vedotin Precautions:

  • This treatment may not be given at the same time as Bleomycin therapy.
  • Before starting brentuximab vedotin treatment, make sure you tell your doctor about anyother medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor’s approval while taking brentuximab vedotin.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Brentuximab vedotin may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.)
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking brentuximab vedotin. Barrier methods of contraception, such as condoms, are recommended.
  • Do not breast feed while taking brentuximab vedotin.

Brentuximab Vedotin Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Follow regimen of anti-diarrhea medication as prescribed by your health care professional.
  • Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
  • Acetaminophen or ibuprofen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
  • Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Brentuximab Vedotin:

Lab work to check blood counts and liver/kidney functions will be checked regularly by your health care professional while you are taking brentuximab vedotin, to monitor side effects and check your response to therapy.

How Brentuximab Vedotin Works:

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly. Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects.

Targeted therapy is about identifying other features of cancer cells. Scientists look for specific differences in the cancer cells and the normal cells. This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects. Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells.

There are different types of targeted therapies, defined in three broad categories. Some targeted therapies focus on the internal components and function of the cancer cell. The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die. There are several types of targeted therapy that focus on the inner parts of the cells. Other targeted therapies target receptors that are on the outside of the cell. Therapies that target receptors are also known as monoclonal antibodies. Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Brentuximab vedotin has the component of an antibody type of targeted therapy. Antibodies are an integral part of the body’s immune system. Normally the body creates antibodies in response to an antigen (such as a protein or a germ) that has entered the body. The antibodies attach to the antigen in order to mark it for destruction by the immune system. To make anti-cancer antibodies in the laboratory, scientists analyze specific antigens on the surface of cancer cells (the targets). Then using animal and human proteins, they create a specific antibody that will attach to the target antigen on the cancer cells. When given to a patient, these antibodies will attach to matching antigens like a key fits a lock. Since antibodies target only specific cells, they may cause less toxicity to healthy cells. Monoclonal antibody therapy is usually only given for cancers in which antigens and the respective antibodies have been identified already.

Brentuximab vedotin is a CD30-directed Antibody Drug conjugate (ADC); meaning that it consists of a targeted therapy monoclonal antibody and an antineoplastic (chemotherapy) agent. These work together to destroy cancer cells.

The brentuximab portion of the drug is a monoclonal antibody which targets the CD30 antigen on the surface of the cancer cells. When it attaches itself, it allows the ADC to enter the cell and disrupt the microtubule network which is part of the structural network of the cell (skeleton). This disruption stops the cell from dividing and copying itself. This disruption ultimately leads to cell death.

Research continues to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer.


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