Monoclonal Antibody Ch14.18
Monoclonal Antibody Ch14.18 Uses, Dosage, Side Effects, Food Interaction and all others data.
Monoclonal Antibody Ch14.18 is an IgG1 monoclonal human/mouse chimeric antibody against GD2, a disialoganglioside expressed on tumors of neuroectodermal origin, including human neuroblastoma and melanoma, with highly restricted expression on normal tissues. It is composed of the variable heavy- and light-chain regions of the murine anti-GD2 mAb 14.18 and the constant regions of human IgG1 heavy-chain and kappa light-chain. By binding to GD2, dinutiximab induces antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity of tumor cells thereby leading to apoptosis and inhibiting proliferation of the tumour. It is indicated, in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy. Despite a high clinical response seen after first-line treatment, the complete eradication of neuroblastoma is rarely achieved and the majority of patients with advanced disease suffer a relapse. Current strategies for treatment include immunotherapy with drugs such as dinutuximab to target surviving neuroblastoma cells and to prevent relapse.
In vitro dinutuximab binds to neuroblastoma tumour cells and mediates the lysis of tumour cells via cell-mediated and complement-mediated cytotoxicity.
Trade Name | Monoclonal Antibody Ch14.18 |
Availability | Prescription only |
Generic | Dinutuximab |
Dinutuximab Other Names | Dinutuximab, Dinutuximab beta, Monoclonal antibody ch14.18 |
Related Drugs | doxorubicin, cisplatin, vincristine, Adriamycin, Danyelza, Platinol |
Type | |
Formula | C6422H9982N1722O2008S48 |
Weight | 145000.0 Da |
Groups | Approved, Investigational |
Therapeutic Class | |
Manufacturer | |
Available Country | |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Monoclonal Antibody Ch14.18 is an immunotherapeutic agent used in combination with other immunomodulating agents to treat high-risk neuroblastoma in pediatric patients who achieve at least a partial response to prior first-line multiagent, multimodality therapy.
Monoclonal Antibody Ch14.18 is indicated, in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy. Despite a high clinical response seen after first-line treatment, the complete eradication of neuroblastoma is rarely achieved and the majority of patients with advanced disease suffer a relapse. Current strategies for treatment include immunotherapy with drugs such as dinutuximab to target surviving neuroblastoma cells and to prevent relapse.
Monoclonal Antibody Ch14.18 is also used to associated treatment for these conditions: High Risk Neuroblastoma
How Monoclonal Antibody Ch14.18 works
Monoclonal Antibody Ch14.18 is an IgG1 monoclonal human/mouse chimeric antibody against GD2, a disialoganglioside expressed on tumors of neuroectodermal origin, including human neuroblastoma and melanoma, with highly restricted expression on normal tissues. It is composed of the variable heavy- and light-chain regions of the murine anti-GD2 mAb 14.18 and the constant regions of human IgG1 heavy-chain and kappa light-chain. By binding to GD2, dinutiximab induces antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity of tumor cells thereby leading to apoptosis and inhibiting proliferation of the tumour.
Toxicity
The most common (incidence 15 %) grade 3 or 4 treatment-related adverse events in dinutuximab compared with standard therapy recipients were neuropathic pain (52 vs. 6 %), fever without neutropenia (39 vs. 6 %), any in-fection (39 vs. 22 %), hypokalaemia (35 vs. 2 %), hypersensitivity reactions (25 vs. 1 %), hyponatraemia (23 vs. 4 %), elevation of alanine transferase levels (23 vs. 3 %) and hypotension (18 vs. 0 %). Based on its mechanism of action, dinutuximab may cause fetal harm when administered to a pregnant woman however, there are no studies in pregnant women and no reproductive studies in animals to inform the drug-associated risk. Non-clinical studies suggest that dinutuximab-induced neuropathic pain is mediated by binding of the antibody to the GD2 antigen located on the surface of peripheral nerve fibers and myelin and subsequent induction of cell- and complement-mediated cytotoxicity. In clinical trials, 114 (85%) patients treated in the dinutuximab/RA group experienced pain despite pre-treatment with analgesics including morphine sulfate infusion. Severe (Grade 3) pain occurred in 68 (51%) patients in the dinutuximab/RA group compared to 5 (5%) patients in the RA group. Pain typically occurred during the dinutuximab infusion and was most commonly reported as abdominal pain, generalized pain, extremity pain, back pain, neuralgia, musculoskeletal chest pain, and arthralgia.
Food Interaction
No interactions found.Monoclonal Antibody Ch14.18 Hypertension interaction
[Major] The use of monoclonal antibodies administered via IV infusion may cause serious infusion reactions, including bronchospasm, hypoxia, dyspnea, fluctuations in blood pressure, laryngeal edema and pulmonary edema.
Caution should be taken in patients with a history of cardiopulmonary disease as they may require additional post-infusion medications to manage respiratory complications.
It is recommended to administer required intravenous hydration and premedication with antihistamines, analgesics, and antipyretics before administration.
Monitor closely for signs and symptoms of infusion reactions during and for at least 4 hours following completion of each infusion in a setting where cardiopulmonary resuscitation medication and equipment are available.
Immediately interrupt or permanently discontinue treatment and institute supportive management for severe or prolonged infusion reactions as appropriate.
Monoclonal Antibody Ch14.18 Drug Interaction
Unknown: charcoal, sulfamethoxazole / trimethoprim, ubiquinone, copper gluconate, glucose, diltiazem, glycerin, sodium iodide, arginine, levocarnitine, cysteine, lithium, metoprolol, metoprolol, acetaminophen, bioflavonoids, valproic acid, thiamine, cyanocobalamin, pyridoxine
Monoclonal Antibody Ch14.18 Disease Interaction
Major: infections, infusion reactions, tumor lysis syndromeModerate: electrolytes abnormalities, hemolytic uremic syndrome, hypotension, myelosuppression, neurotoxicity, posterior leukoencephalopathy syndrome
Volume of Distribution
The mean volume of distribution at steady state (Vdss) is 5.4 L
Half Life
The terminal half-life is 10 days
Clearance
The clearance is 0.21 L/day and increases with body size
Innovators Monograph
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