What are some of the more common adverse reactions associated with brentuximab vedotin and how are they most often managed?

Clinical Pearls Podcasts published on April 7, 2017
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Alison J. Moskowitz, MD
Assistant Professor
Memorial Sloan Kettering Cancer Center
Instructor in Medicine
Weill Cornell Medical College
New York, New York
What are some of the more common adverse reactions associated with brentuximab vedotin and how are they most often managed?

Hi. I am Dr. Alison Moskowitz. Over the next few minutes I am going to be talking about some of the more common adverse reactions we see associated with brentuximab vedotin and how those reactions are managed. One of the most common side effects we see with brentuximab is neuropathy, particularly sensory neuropathy. This occurs in about 50% of patients who are treated. Typically we see this somewhere between cycle 4 to 6 of treatment and it is most commonly seen earlier on in the treatment. Typically the sensory neuropathy can be managed with dose reductions. The standard dose for brentuximab is 1.8 mg/kg and the reduction for neuropathy is typically 1.2 mg/kg. For patients with more significant symptoms, we can also delay dosing and allow improvement of the symptoms before restarting at a lower dose. Less commonly seen is motor neuropathy which has been reported in about 16% of patients, and typically this would be managed similarly as sensory neuropathy. Other common side effects that can be seen with brentuximab is rash, which in the main clinical trials in which brentuximab was studied, the frequency of rash was reported in about 27% of patients. Typically I believe that this is seen more often, likely because the patients who are now receiving brentuximab are less heavily pretreated and I think the frequency of rash is more like 50%. Rash can typically be managed with topical steroids, and often with treatment with topical steroids patients can continue on with treatment. Very rarely brentuximab has been associated though with Stevens-Johnson syndrome, so certainly you would want to be careful of patients developing severe rashes. A less common side effect but one to be aware of associated with brentuximab is hyperglycemia, which was reported in the post-marketing setting, so it is something to be monitoring for. And then also brentuximab can also commonly cause symptoms such as fatigue and constipation, and occasionally can be associated with infusion-related reactions. Thank you for your attention.

Last modified: April 5, 2017
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