Catumaxomab

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Catumaxomab
Monoclonal antibody
Type Trifunctional antibody
Source Rat/mouse hybrid
Target EpCAM, CD3
Clinical data
Trade names Removab
AHFS/Drugs.com International Drug Names
Licence data EMA:Link
Legal status
  • ℞ (Prescription only)
Routes of
administration		 intraperitoneal infusion
Identifiers
CAS Number 509077-98-9 N
ATC code L01XC09 (WHO)
 NYesY (what is this?)  (verify)

Catumaxomab[1] (trade name Removab) is a rat-mouse hybrid monoclonal antibody which is used to treat malignant ascites, a condition occurring in patients with metastasizing cancer. It binds to antigens CD3 and EpCAM. It is in clinical trials in the United States currently and is used in Europe. It was developed by Fresenius Biotech and Trion Pharma (Germany).

History

Catumaxomab was developed by Trion Pharma, based on preliminary work by the Helmholtz Zentrum München. Dr. Horst Lindhofer is listed at the primary inventor of the patent.[2] Fresenius Biotech conducted clinical trials and filed the drug for approval with the European Medicines Agency (EMA). It was approved in Europe on 20 April 2009.[3]

Indications

The drug is approved for the treatment of malignant ascites in patients with EpCAM-positive cancer if a standard therapy is not available.[4][5] Ascites is an accumulation of fluid in the peritoneal cavity.

Application

The usual treatment of malignant ascites is to puncture the peritoneum to let the accumulated fluid drain out. After the puncture, catumaxomab is given as an intraperitoneal infusion. The procedure is repeated four times within about eleven days. It has been shown that puncture free survival can be increased from 11 to 46 days with this treatment.[6]

Adverse effects

Common adverse effects include fever, nausea and vomiting. Fever and pain should be controlled by giving NSAIDs, analgetics or antipyretics before application of catumaxomab.[7] All side effects were fully reversible in studies. Most are caused by the liberation of cytokines.[8]

Chemical structure

Catumaxomab consists of one "half" (one heavy chain and one light chain) of an anti-EpCAM antibody and one half of an anti-CD3 antibody, so that each molecule of catumaxomab can bind both EpCAM and CD3. In addition, the Fc-region can bind to an Fc receptor on accessory cells like other antibodies, which has led to calling the drug a trifunctional antibody.

Catumaxomab structure.svg

Mechanism of action

Many types of cancer cells carry EpCAM (epithelial cell adhesion molecule) on their surface. By binding to such a cell via one arm, to a T lymphocyte via the other arm and to an antigen-presenting cell like a macrophage, a natural killer cell or a dendritic cell via the heavy chains, an immunological reaction against the cancer cell is triggered. Removing cancer cells from the abdominal cavity reduces the tumour burden which is seen as the cause for ascites in cancer patients.[8][9][10]

Catumaxomab mechanism.svg

References

  1. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  2. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  3. ↑ TRION Pharma: Trifunctional Antibody Catumaxomab Kills Cancer Stem Cells
  4. ↑ European Public Assessment Report for Removab
  5. ↑ Heiss u.a.: The trifunctional antibody catumaxomab for the treatment of malignant ascites due to epithelial cancer: results of a prospective randomized phase II/III trial. Int J Cancer. (2010) 127: 2209-2221
  6. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  7. ↑ Schubert-Zsilavecz, M, Wurglics, M, Neue Arzneimittel 2009
  8. ↑ 8.0 8.1 Assessment Report for Removab
  9. ↑ Capital Market Day Fresenius Biotech: Fresenius concentrates biotechnology activities on antibody and innovative cell therapies
  10. ↑ Lua error in package.lua at line 80: module 'strict' not found.

External links

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