Siltuximab

Last updated

Siltuximab
Monoclonal antibody
Type Whole antibody
Source Chimeric (mouse/human)
Target IL-6
Clinical data
Trade names Sylvant
Other namesCNTO 328
License data
ATC code
Legal status
Legal status
Identifiers
CAS Number
DrugBank
ChemSpider
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UNII
KEGG
ChEMBL
Chemical and physical data
Formula C6450H9932N1688O2016S50
Molar mass 144983.21 g·mol−1
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Siltuximab (INN [4] ), sold under the brand name Sylvant, is used for the treatment of people with multicentric Castleman's disease. [2] [3] It is a chimeric (made from human and mouse proteins) monoclonal antibody that binds to interleukin-6. It is an interleukin-6 (IL-6) antagonist. [2]

Contents

The common adverse reactions include pruritus, increased weight, rash, hyperuricemia, and upper respiratory tract infection. [5]

In April 2014, siltuximab was approved for medical use in the United States for the treatment of people with multicentric Castleman's disease who do not have human immunodeficiency virus (HIV) or human herpesvirus-8 (HHV-8). [5] [6]

Medical uses

Siltuximab is indicated for the treatment of people with multicentric Castleman's disease who are human immunodeficiency virus (HIV) negative and human herpesvirus-8 (HHV-8) negative. [2] [3]

Side effects

The common adverse reactions include pruritus, increased weight, rash, hyperuricemia, and upper respiratory tract infection. [5]

Drug interactions

Siltuximab may increase CYP450 activity leading to increased metabolism of drugs that are CYP450 substrates. [2]

Mechanism of action

Siltuximab is a chimeric monoclonal antibody that binds to interleukin-6 (IL-6), preventing binding to soluble and membrane bound interleukin-6 receptors. Siltuximab interferes with IL-6 mediated growth of B-lymphocytes and plasma cells, secretion of vascular endothelial growth factor (VEGF) and autoimmune phenomena. [2]

History

Siltuximab demonstrated efficacy and safety in people with idiopathic multicentric Castleman disease. [7] [8] Treatment results with siltuximab in B-cell non-Hodgkin's lymphoma are inferior to those obtained in multicentric Castleman disease. [9]

The approval by the US FDA was based on an international, multicenter, randomized (2:1), phase II study comparing every three-week intravenous infusions of siltuximab and best supportive care to placebo and best supportive care. [5] The trial enrolled 79 participants and randomly allocated 53 participants to the siltuximab arm plus best supportive care and 26 participants randomized to the placebo arm plus best supportive care. [5] Siltuximab was administered every three weeks as an intravenous infusion at a dose of 11 mg/kg. [5]

Research

Siltuximab has been investigated for the treatment of neoplastic diseases: [10] metastatic renal cell cancer, [11] prostate cancer, [12] other types of cancer, [13] and for Castleman's disease. [14] [15]

Siltuximab has been evaluated in the treatment of ovarian cancer, however the efficacy for this cancer is debatable. [16] In addition, siltuximab has been evaluated for multiple myeloma, but there was an insignificant increase in response rates. [17]

Related Research Articles

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Castlemandisease (CD) describes a group of rare lymphoproliferative disorders that involve enlarged lymph nodes, and a broad range of inflammatory symptoms and laboratory abnormalities. Whether Castleman disease should be considered an autoimmune disease, cancer, or infectious disease is currently unknown.

<span class="mw-page-title-main">POEMS syndrome</span> Paraneoplastic syndrome

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<span class="mw-page-title-main">Kaposi's sarcoma-associated herpesvirus</span> Species of virus

Kaposi's sarcoma-associated herpesvirus (KSHV) is the ninth known human herpesvirus; its formal name according to the International Committee on Taxonomy of Viruses (ICTV) is Human gammaherpesvirus 8, or HHV-8 in short. Like other herpesviruses, its informal names are used interchangeably with its formal ICTV name. This virus causes Kaposi's sarcoma, a cancer commonly occurring in AIDS patients, as well as primary effusion lymphoma, HHV-8-associated multicentric Castleman's disease and KSHV inflammatory cytokine syndrome. It is one of seven currently known human cancer viruses, or oncoviruses. Even after many years since the discovery of KSHV/HHV8, there is no known cure for KSHV associated tumorigenesis.

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<span class="mw-page-title-main">Primary effusion lymphoma</span> Medical condition

Primary effusion lymphoma (PEL) is classified as a diffuse large B cell lymphoma. It is a rare malignancy of plasmablastic cells that occurs in individuals that are infected with the Kaposi's sarcoma-associated herpesvirus. Plasmablasts are immature plasma cells, i.e. lymphocytes of the B-cell type that have differentiated into plasmablasts but because of their malignant nature do not differentiate into mature plasma cells but rather proliferate excessively and thereby cause life-threatening disease. In PEL, the proliferating plasmablastoid cells commonly accumulate within body cavities to produce effusions, primarily in the pleural, pericardial, or peritoneal cavities, without forming a contiguous tumor mass. In rare cases of these cavitary forms of PEL, the effusions develop in joints, the epidural space surrounding the brain and spinal cord, and underneath the capsule which forms around breast implants. Less frequently, individuals present with extracavitary primary effusion lymphomas, i.e., solid tumor masses not accompanied by effusions. The extracavitary tumors may develop in lymph nodes, bone, bone marrow, the gastrointestinal tract, skin, spleen, liver, lungs, central nervous system, testes, paranasal sinuses, muscle, and, rarely, inside the vasculature and sinuses of lymph nodes. As their disease progresses, however, individuals with the classical effusion-form of PEL may develop extracavitary tumors and individuals with extracavitary PEL may develop cavitary effusions.

<i>Herpesviridae</i> Family of DNA viruses

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<span class="mw-page-title-main">Idiopathic multicentric Castleman disease</span> Medical condition

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References

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