Brentuximab Dosage

Medically reviewed by Drugs.com. Last updated on Feb 29, 2024.

Usual Adult Dose for Hodgkin's Disease

For previously untreated stage III or IV classical Hodgkin lymphoma (cHL): 1.2 mg/kg IV every 2 weeks
Maximum dose: 120 mg/dose
Duration of therapy: Until a maximum of 12 doses, disease progression, or unacceptable toxicity

For cHL consolidation: 1.8 mg/kg IV every 3 weeks
Maximum dose: 180 mg/dose
Duration of therapy: Until a maximum of 16 cycles, disease progression, or unacceptable toxicity

For relapsed cHL: 1.8 mg/kg IV every 3 weeks
Maximum dose: 180 mg/dose
Duration of therapy: Until disease progression or unacceptable toxicity

Comments:

• For previously untreated stage III or IV classical cHL: To be used in combination with chemotherapy; granulocyte colony-stimulating factor (G-CSF) should be administered starting with cycle 1.
• For cHL consolidation: This drug should be started within 4 to 6 weeks post-autologous hematopoietic stem cell transplantation (auto-HSCT) or upon recovery from auto-HSCT.

Uses:

• In combination with doxorubicin, vinblastine, and dacarbazine, for the treatment of patients with previously untreated stage III or IV cHL
• For the treatment of patients with cHL at high risk of relapse or progression as post-auto-HSCT consolidation
• For the treatment of patients with cHL after failure of auto-HSCT or after failure of at least 2 prior multi-agent chemotherapy regimens in patients who are not auto-HSCT candidates

Usual Adult Dose for Mycosis Fungoides

For previously untreated systemic anaplastic large cell lymphoma (ALCL) or other CD30 (cluster of differentiation 30)-expressing peripheral T-cell lymphomas (PTCL): 1.8 mg/kg IV every 3 weeks with each cycle of chemotherapy
Maximum dose: 180 mg/dose
Duration of therapy: 6 to 8 doses

For relapsed systemic ALCL: 1.8 mg/kg IV every 3 weeks
Maximum dose: 180 mg/dose
Duration of therapy: Until disease progression or unacceptable toxicity

For relapsed primary cutaneous ALCL or CD30-expressing mycosis fungoides: 1.8 mg/kg IV every 3 weeks
Maximum dose: 180 mg/dose
Duration of therapy: Until a maximum of 16 cycles, disease progression, or unacceptable toxicity

Comments:

• For previously untreated systemic ALCL or other CD30-expressing PTCL: To be used in combination with chemotherapy
• In patients with previously untreated PTCL, G-CSF should be administered starting with cycle 1.

Uses:

• In combination with cyclophosphamide, doxorubicin, and prednisone, for the treatment of patients with previously untreated systemic ALCL or other CD30-expressing PTCL, including angioimmunoblastic T-cell lymphoma and PTCL not otherwise specified
• For the treatment of patients with systemic ALCL after failure of at least 1 prior multi-agent chemotherapy regimen
• For the treatment of patients with primary cutaneous ALCL or CD30-expressing mycosis fungoides who have received prior systemic therapy

Usual Adult Dose for Lymphoma

For previously untreated systemic anaplastic large cell lymphoma (ALCL) or other CD30 (cluster of differentiation 30)-expressing peripheral T-cell lymphomas (PTCL): 1.8 mg/kg IV every 3 weeks with each cycle of chemotherapy
Maximum dose: 180 mg/dose
Duration of therapy: 6 to 8 doses

For relapsed systemic ALCL: 1.8 mg/kg IV every 3 weeks
Maximum dose: 180 mg/dose
Duration of therapy: Until disease progression or unacceptable toxicity

For relapsed primary cutaneous ALCL or CD30-expressing mycosis fungoides: 1.8 mg/kg IV every 3 weeks
Maximum dose: 180 mg/dose
Duration of therapy: Until a maximum of 16 cycles, disease progression, or unacceptable toxicity

Comments:

• For previously untreated systemic ALCL or other CD30-expressing PTCL: To be used in combination with chemotherapy
• In patients with previously untreated PTCL, G-CSF should be administered starting with cycle 1.

Uses:

• In combination with cyclophosphamide, doxorubicin, and prednisone, for the treatment of patients with previously untreated systemic ALCL or other CD30-expressing PTCL, including angioimmunoblastic T-cell lymphoma and PTCL not otherwise specified
• For the treatment of patients with systemic ALCL after failure of at least 1 prior multi-agent chemotherapy regimen
• For the treatment of patients with primary cutaneous ALCL or CD30-expressing mycosis fungoides who have received prior systemic therapy

Usual Pediatric Dose for Hodgkin's Disease

2 years and older: 1.8 mg/kg IV every 3 weeks with each cycle of chemotherapy
Maximum dose: 180 mg/dose
Duration of therapy: For a maximum of 5 doses

Comments:

• To be used in combination with chemotherapy
• G-CSF should be administered starting with cycle 1.

Use: In combination with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide, for the treatment of patients with previously untreated high risk cHL

Renal Dose Adjustments

Mild to moderate renal dysfunction (CrCl 30 to 80 mL/min): No adjustment recommended
Severe renal dysfunction (CrCl less than 30 mL/min): Not recommended

Liver Dose Adjustments

Adult patients with previously untreated stage III or IV cHL:

• Mild liver dysfunction (Child-Pugh A): 0.9 mg/kg IV every 2 weeks
• Maximum dose: 90 mg/dose
• Moderate or severe liver dysfunction: (Child-Pugh B or C): Not recommended

All other indications:

• Mild liver dysfunction (Child-Pugh A): 1.2 mg/kg IV every 3 weeks
• Maximum dose: 120 mg/dose
• Moderate or severe liver dysfunction: (Child-Pugh B or C): Not recommended

Dose Adjustments

DOSAGE MODIFICATIONS FOR PERIPHERAL NEUROPATHY OR NEUTROPENIA IN ADULT PATIENTS:
Peripheral Neuropathy:
For recommended dosage of 1.2 mg/kg (up to 120 mg) IV every 2 weeks in combination with chemotherapy:

• Grade 2: Dose should be reduced to 0.9 mg/kg (up to 90 mg) IV every 2 weeks
• Grade 3: Dosing of this drug should be held until improvement to grade 2 or lower; should restart at 0.9 mg/kg (up to 90 mg) IV every 2 weeks
• Modifying the dose of other neurotoxic chemotherapy agents should be considered.
• Grade 4: Dosing should be discontinued.

For recommended dosage of 1.8 mg/kg (up to 180 mg) IV every 3 weeks as monotherapy:

• New or worsening grade 2 or 3: Dosing should be held until improvement to baseline or grade 1; should restart at 1.2 mg/kg (up to 120 mg) IV every 3 weeks
• Grade 4: Dosing should be discontinued.

For recommended dosage of 1.8 mg/kg (maximum dose: 180 mg) IV every 3 weeks in combination with chemotherapy:

• Grade 2:
• Motor neuropathy: Should reduce dose to 1.2 mg/kg (up to 120 mg) IV every 3 weeks
• Sensory neuropathy: Therapy should continue at the same dose.
• Grade 3:
• Motor neuropathy: Dosing should be discontinued.
• Sensory neuropathy: Should reduce dose to 1.2 mg/kg (up to 120 mg) IV every 3 weeks
• Grade 4: Dosing should be discontinued.

Neutropenia:
For recommended dosage of 1.2 mg/kg (up to 120 mg) IV every 2 weeks in combination with chemotherapy:

• Grade 3 or 4: G-CSF prophylaxis should be administered for subsequent cycles for patients not receiving primary G-CSF prophylaxis.

For recommended dosage of 1.8 mg/kg (up to 180 mg) IV every 3 weeks as monotherapy:

• Grade 3 or 4: Dosing should be held until improvement to baseline or grade 2 or lower; G-CSF prophylaxis should be considered for subsequent cycles.
• Recurrent grade 4 despite G-CSF prophylaxis: Discontinuation or dose reduction to 1.2 mg/kg (up to 120 mg) IV every 3 weeks should be considered.

For recommended dosage of 1.8 mg/kg (maximum dose: 180 mg) IV every 3 weeks in combination with chemotherapy:

• Grade 3 or 4: G-CSF prophylaxis should be administered for subsequent cycles for patients not receiving primary G-CSF prophylaxis.

DOSAGE MODIFICATIONS FOR PERIPHERAL NEUROPATHY OR NEUTROPENIA IN PEDIATRIC PATIENTS:
Peripheral Neuropathy (assessed using the Balis scale):
For recommended dosage of 1.8 mg/kg (up to 180 mg) IV every 3 weeks:

• Grade 2: Vincristine dose should be reduced per the manufacturer product information; dosing with this drug should continue.
• If neuropathy improves to grade 1 or lower, then vincristine should resume at full dose.
• Grade 3: Vincristine should be discontinued.
• First occurrence: Dosing of this drug should be held until improvement to grade 2 or lower, then should restart at 1.2 mg/kg (up to 120 mg)
• Second occurrence: Should hold until improvement to grade 2 or lower, then should restart at 0.8 mg/kg (up to 80 mg)
• Third occurrence: This drug should be discontinued.
• Grade 4: This drug and vincristine should be discontinued.

Neutropenia:
For recommended dosage of 1.8 mg/kg (up to 180 mg) IV every 3 weeks:

• Grade 3 or 4: Should reduce dose to 1.2 mg/kg (up to 120 mg) IV every 3 weeks in patients who are unable to start a cycle more than 5 weeks after the start of the previous cycle (more than 2-week delay) due to neutropenia

Precautions

US BOXED WARNING:

• PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY (PML): John Cunningham virus (JC virus) infection resulting in PML and death can occur in patients receiving this drug.

CONTRAINDICATIONS:

• Concomitant bleomycin (due to pulmonary toxicity [e.g., interstitial infiltration and/or inflammation])

Safety and efficacy have not been established in patients younger than 2 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Administer as an IV infusion only; infuse over 30 minutes.
• Do not mix with, or administer as an infusion with, other medicinal products.
• Monitor patients during infusion.

Storage requirements:

• Vial: Store at 2C to 8C (36F to 46F) in original carton to protect from light.
• Reconstituted solution: If not diluted immediately, store at 2C to 8C (36F to 46F) and use within 24 hours of reconstitution; do not freeze.
• Diluted solution: If not used immediately, store at 2C to 8C (36F to 46F) and use within 24 hours of reconstitution; do not freeze.

Reconstitution/preparation techniques:

• After reconstitution, this drug should be diluted immediately into an infusion bag.
• The manufacturer product information should be consulted.

IV compatibility:

• Compatible: Sterile Water for Injection, USP; 0.9% Sodium Chloride Injection, USP; 5% Dextrose Injection, USP; Lactated Ringer's Injection, USP

General:

• This drug is a hazardous product; special handling and disposal procedures should be followed.
• For dosing instructions of combination agents administered with this drug, the manufacturer product information for each agent should be consulted.
• The dose for patients weighing more than 100 kg should be calculated based on a weight of 100 kg.

Monitoring:

• General: For fever
• Hematologic: CBC (before each dose; more often with grade 3/4 neutropenia)
• Hepatic: Liver enzymes and bilirubin
• Infections/Infestations: For possible bacterial, fungal, or viral infections
• Metabolic: For tumor lysis syndrome; serum glucose
• Nervous System: For symptoms of neuropathy
• Respiratory: For signs/symptoms of pulmonary toxicity

Patient advice:

• Report to health care provider any numbness or tingling of the hands/feet or any muscle weakness.
• Contact health care provider if a fever of 100.5F or greater or other evidence of potential infection (e.g., chills, cough, pain on urination) develops.
• Contact health care provider if signs/symptoms of infusion reactions (including fever, chills, rash, or breathing problems) occur within 24 hours of infusion.
• Report symptoms that may indicate liver injury (including fatigue, anorexia, right upper abdominal discomfort, dark urine, or jaundice) or pulmonary toxicity (including cough or shortness of breath).
• Immediately report if you have any of the following neurological, cognitive, or behavioral signs/symptoms or if anyone close to you notices these signs/symptoms: changes in mood or usual behavior; confusion, thinking problems, loss of memory; changes in vision, speech, or walking; decreased strength or weakness on 1 side of the body.
• Contact health care provider if severe abdominal pain, chills, fever, nausea, vomiting, or diarrhea develops.
• Patients of childbearing potential: Use effective contraception during therapy and for 2 months after the last dose.
• Male patients with sexual partners of childbearing potential: Use effective contraception during therapy and for 4 months after the last dose.
• Report pregnancy immediately.
• Avoid breastfeeding during therapy.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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