Advantages of drug selective distribution in cancer treatment: Brentuximab vedotin

Abstract

Medical practice has different forms of treatments for cancer. Different challenges are presented in chemotherapy, limited therapeutic efficacy as single drugs, needed to increase doses or co-administration with other cytotoxic, high frequency and severity of adverse events, due low selectivity of drugs. Researchers have innovated in the treatment of cancer, either by creating selective drug delivery systems or by drugs specifically designed to a unique target site of action. This has not just improved the therapeutic efficacy but also limited the adverse events. Some innovations have been focused on exploiting the selectivity properties of the antigen-antibody reactions, which has allowed the development of therapeutic antibodies. Antibodies can destroy cancer cells by different mechanisms. Some can activate apoptosis pathways directly. Other are linked with cytotoxic drugs that are released into the tumor cells when they have been incorporated by the process of endocytosis (Trojan horse phenomenon). Lymphoproliferative syndromes have gotten benefit from these innovations. Most of the treatment regimens use “traditional” drugs on combinations (i.e., CHOP= cyclophosphamide, doxorubicin, vincristine, prednisone for Non-Hodgkin's lymphoma or ABVD = doxorubicin, bleomycin, vinblastine, dacarbacyne; for Hodgkin's lymphoma) that have good therapeutic efficacy but low selectivity. The introduction of monoclonal antibody therapy (mAb) or conjugated antibody therapy (ADCs) have increased disease-free survival and some types of lymphoma overall survival. In this review we make a great approach to mAb and ADC, from the development of these innovative drugs to the clinical use of them, showing the results obtained in different trials, as well as their adverse effects and monitoring as part of pharmacovigilance which they must have.