Conjugated agents

Oxford American handbook of oncology. Second Edition. Oxford University Press (2015)


Conjugated agents consist of an antibody or protein linked to a toxin or radioisotope. This class of drugs confers specificity by localizing the cytotoxic insult to the malignant cell of interest. Available conjugated agents include the following.

Ibritumomab (Zevalin)

  • Mechanism: CD20 antibody conjugated to the radioisotope Yttrium-90. Binds to B -cells, delivering local radiation
  • Route: intravenous
  • Uses: B -cell lymphomas, particularly follicular lymphoma
  • Notes: can cause prolonged myelosuppression

Tositumomab (Bexxar)

  • Mechanism: antibody to the B -cell marker CD20 that is conjugated to the radioisotope iodine-131, which binds and delivers local radiation to target cells
  • Route: intravenous
  • Uses: B -cell lymphomas, particularly follicular lymphoma
  • Notes: can cause prolonged myelosuppression

Denileukin diftitox (Ontak)

  • Mechanism: interleukin-2 conjugated to the diphtheria toxin, which binds to lymphocytes and inhibits protein synthesis
  • Route: intravenous
  • Uses: cutaneous T-cell lymphoma
  • Notes: can cause hypersensitivity reactions, increased risk of infections, “vascular leak ” syndrome, and risk of thrombosis
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