Adcetris (brentuximab vedotin) vs Xalkori (crizotinib)

Adcetris (brentuximab vedotin) is an antibody-drug conjugate specifically designed to treat certain types of lymphomas, including Hodgkin lymphoma and systemic anaplastic large cell lymphoma, by targeting the CD30 antigen on cancer cells. Xalkori (crizotinib), on the other hand, is a small molecule tyrosine kinase inhibitor used to treat non-small cell lung cancer (NSCLC) that is positive for the anaplastic lymphoma kinase (ALK) mutation or ROS1-positive advanced NSCLC. The choice between Adcetris and Xalkori would largely depend on the specific type of cancer a patient has, as they are targeted therapies designed for different cancer markers and are not interchangeable.

Difference between Adcetris and Xalkori

Metric	Adcetris (brentuximab vedotin)	Xalkori (crizotinib)
Generic name	Brentuximab vedotin	Crizotinib
Indications	Hodgkin lymphoma, systemic anaplastic large cell lymphoma, primary cutaneous anaplastic large cell lymphoma, and certain types of mycosis fungoides	Non-small cell lung cancer (NSCLC) with specific genetic alterations (ALK or ROS1-positive), and anaplastic large-cell lymphoma
Mechanism of action	CD30-directed antibody-drug conjugate	ALK and ROS1 tyrosine kinase inhibitor
Brand names	Adcetris	Xalkori
Administrative route	Intravenous infusion	Oral
Side effects	Peripheral neuropathy, neutropenia, fatigue, nausea, anemia, upper respiratory tract infection, diarrhea, fever, rash, thrombocytopenia, cough, and vomiting	Visual disorders, gastrointestinal effects, edema, dizziness, neuropathy, elevated transaminases, fatigue, decreased appetite, upper respiratory infection, dysgeusia, and constipation
Contraindications	Hypersensitivity to brentuximab vedotin or any excipient	Hepatic impairment, QT interval prolongation, bradycardia, use of strong CYP3A inhibitors or inducers
Drug class	Antineoplastic agent, monoclonal antibody	Antineoplastic agent, tyrosine kinase inhibitor
Manufacturer	Seagen Inc.	Pfizer Inc.

Efficacy

Adcetris (Brentuximab Vedotin) Efficacy in Lymphoma

Adcetris (brentuximab vedotin) is an antibody-drug conjugate specifically indicated for the treatment of several types of lymphoma. It is approved for use in classical Hodgkin lymphoma (HL) after failure of other treatments, such as autologous stem cell transplant (ASCT) or at least two prior multi-agent chemotherapy regimens in patients who are not ASCT candidates. It has also shown efficacy in systemic anaplastic large cell lymphoma (ALCL) and certain types of cutaneous T-cell lymphoma (CTCL). The efficacy of Adcetris in lymphoma is attributed to its mechanism of action, which involves targeting the CD30 antigen on lymphoma cells and delivering a potent cytotoxic agent, monomethyl auristatin E (MMAE), leading to cell death.

Clinical trials have demonstrated the efficacy of Adcetris in inducing complete and partial remissions in patients with relapsed or refractory HL and systemic ALCL. In pivotal trials, a significant proportion of patients achieved an objective response, with some experiencing durable remissions. The drug's effectiveness has led to its adoption as a key therapeutic agent in the management of these lymphomas, particularly for patients who have limited treatment options due to the refractory nature of their disease.

Xalkori (Crizotinib) Efficacy in Lymphoma

Xalkori (crizotinib) is primarily known for its use in the treatment of non-small cell lung cancer (NSCLC) with specific genetic alterations. However, its efficacy in lymphoma, particularly in ALK-positive anaplastic large cell lymphoma (ALCL), has been investigated due to its mechanism of action as an ALK inhibitor. ALK-positive ALCL is a subtype of non-Hodgkin lymphoma characterized by the presence of the ALK protein, which crizotinib targets. While Xalkori is not universally approved for lymphoma treatment, its off-label use in ALK-positive ALCL has been explored in clinical settings.

Early clinical studies and case reports suggest that crizotinib may have activity in patients with ALK-positive ALCL, with some patients achieving complete or partial responses. However, the evidence for its use in lymphoma is not as robust as for its approved indications, and further clinical trials are needed to fully establish its efficacy and safety profile in this patient population. As such, Xalkori's use in lymphoma remains investigational and is generally considered when other, more established treatment options are not suitable or have failed.

Regulatory Agency Approvals

Adcetris

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Therapeutic Goods Administration (TGA), Australia
NMPA (China)

Xalkori

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Therapeutic Goods Administration (TGA), Australia

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