Indications, usage, dosage and precautions of Vidicitomab (Aidexi)

Disitamab (Disitamab Vedotin, trade name "Aidexi") is a tumor-targeting antibody-drug conjugate (ADC), which consists of a monoclonal antibody targeting HER2 (human epidermal growth factor receptor-2) and a cytotoxic drug MMAE (monomethyl auristatin E) coupled. Its mechanism of action is that the antibody part specifically binds to the HER2 protein on the surface of tumor cells. After entering the cells, it releases MMAE, blocking cell mitosis and inducing apoptosis by destroying the microtubule structure. At the same time, the antibody part can also inhibit the HER2 signaling pathway and mediate antibody-dependent cytotoxicity, enhancing the anti-tumor effect.

Vedicitumab is mainly used to treat HER2 solid tumors. The currently approved indications are patients with locally advanced or metastatic gastric cancer and gastroesophageal junction adenocarcinoma who overexpress HER2 (IHC 2+ or 3+ ) and have experienced at least two types of systemic chemotherapy. In addition, the study of this drug in urothelial cancer is also advancing, and some clinical trials have shown that its combination with immune checkpoint inhibitors can be effective in locally advanced or metastatic urothelial cancer. Early exploratory studies are also exploring its use in breast cancer and other HER2-related tumors, but these uses have not yet become standard treatments.

In terms of usage and dosage, the standard regimen for metastatic gastric cancer is 2.5 mg/kg per time Intravenous infusion based on body weight, once every two weeks. The infusion should be carried out slowly, usually about 60 minutes, and intravenous bolus or rapid intravenous infusion should be avoided. If allergic reactions or infusion-related reactions occur during the infusion process, the infusion should be slowed down or interrupted immediately and symptomatic treatment should be taken. If severe, the medication should be stopped. Different research plans may have slight adjustments in combination therapy or indications, and the specific dosage and dosage rhythm must be determined by the attending physician based on the patient's condition.

During the use of vedesitomab, attention should be paid to hematological toxicity, including neutropenia, anemia and thrombocytopenia. Blood routine should be monitored regularly and supportive treatment should be provided if necessary. Adverse digestive reactions such as nausea, vomiting, diarrhea, and loss of appetite are also common and can be alleviated through dietary modification or drug intervention. Attention also needs to be paid to liver function abnormalities, peripheral neuropathy, and possibly cardiotoxicity and interstitial lung disease in a minority of patients. It is contraindicated for pregnant women and lactating women, and patients of childbearing age should take effective contraceptive measures. Patients should be treated under the guidance of professional oncologists, and blood routine, liver and kidney function, cardiac function and nervous system status should be reviewed regularly to ensure efficacy and safety.

The emergence of vedicitumab provides a new treatment option for HER2 overexpressed advanced gastric cancer patients, and also provides the possibility for the research of other HER2 related solid tumors. Patients must strictly follow medical instructions during use, closely monitor adverse reactions, and comprehensively evaluate efficacy and risks to obtain the best therapeutic effect. As more clinical trials and research progress, its application prospects in urothelial cancer and other tumors will gradually become clearer, providing patients with more accessible targeted treatment options.

Reference materials:https://pubmed.ncbi.nlm.nih.gov/38940019/