淋巴瘤治療的新藥：Brentuximab Vedotin (Adcetris)

A Novel Drug of Lymphoma Treatments: Brentuximab Vedotin (Adcetris)

CD30在正常細胞表現非常有限，但在某些惡性血液腫瘤具有高度且一致的表現，例如典型何杰金氏淋巴瘤(classical Hodgkin lymphoma, cHL)與全身性退行分化型大細胞淋巴瘤(systemic anaplastic large cell lymphoma, sALCL)，因此成為一個治療研究的標的。不同於傳統免疫治療，Brentuximab vedotin是一個Anti-CD30單株抗體藥物複合體(antibody-drug conjugate)，藉由瞄準CD30受體，將抗腫瘤藥物釋放到腫瘤細胞，經由兩個第二期臨床試驗，已被證實對於復發及頑固型CD30+何杰金氏淋巴瘤(relapse/refractory HL)，以及復發及頑固型全身性退行分化型大細胞淋巴瘤(relapse/refractory sALCL)具有 高度療效及良好的耐受性。對照歷史資料的整合性分析，顯示比其他治療具有更長的存活期中數值(median survival)。至於其他的CD30+惡性疾病，相關的臨床試驗也正在進行中。Brentuximab vedotin已於2016年6月以突破創新級新藥通過台灣健保給付，可望為癌症治療增添重要有力生力軍。

CD30 expression on normal cells is restricted, but the expression is strong and uniform on malignant cells in some hematologic malignancies, such as classic Hodgkin’s lymphoma (cHL) and anaplastic large cell lymphoma (ALCL). Therefore, CD30 has become an attractive target for treatment researches. Brentuximab vedotin is an anti-CD30 antibody-drug conjugate (ADC). Unlike conventional antibody-based immunotherapy, anti-CD30 ADCs deliver a cytotoxic agent into the malignant cells by utilizing the targeting CD30 properties of the monoclonal antibody (mAb). It has been demonstrated that anti-CD30 ADC had high efficacy and favorable tolerance in patients with relapse/refractory CD30+ Hodgkin’s lymphoma and relapse/refractory systemic ALCL in two phase II trials, respectively. Additionally, anti-CD30 ADC improved long-term survival when compared with other therapies in a meta-analysis versus historical data. The clinical trials evaluating brentuximab vedotin in other CD30+ malignancies are also under way. Brentuximab vedotin has been recognized as a breakthrough drug by Taiwan’s National Health Insurance Administration and got reimbursement in June, 2016. It is expected to be a critical and robust aid for cancer therapy in the coming future.