Idecabtagene vicleucel // ABECMA
CAR-T ( Chimeric antigen receptor -T cell therapy)
MECHANISM OF ACTION
ABECMA is a chimeric antigen receptor (CAR)-positive T cell therapy targeting B-cell maturation antigen (BCMA), which is expressed on the surface of normal and malignant plasma cells. The CAR construct includes an anti-BCMA scFv-targeting domain for antigen specificity, a transmembrane domain, a CD3-zeta T cell activation domain, and a 4-1BB costimulatory domain. Antigen-specific activation of ABECMA results in CAR-positive T cell proliferation, cytokine secretion, and subsequent cytolytic killing of BCMA-expressing cells// Route of drug elimination is N/A
MECHANISM OF KIDNEY INJURY
renal injury seems to be related to CRS - decreased kidney perfusion vs ATN (but unsure from this drug as no studies done to determined the cause)
CLINICAL KIDNEY SYNDROME
Fluid extravasation/Capillary leak syndrome, Hypotension
CARDIOVASCULAR ADVERSE EFFECTS
LYTE ABNORMALITIES
Hypophosphatemia, Hypocalcemia, Hypokalemia, Hypoalbuminemia, Hyponatremia, Hypomagnesemia
RISK FACTORS
MITIGATION STRATEGIES
n/a
SUGGESTIONS
Treat CRS if present
NOTES/COMMENTS
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PHARMACOKINETICS
Molecular Weight
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Volume of Distribution
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Plasma Protein Binding
Metabolism
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Bioavailability
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Half-life elimination
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Time to peak
Maximal expansion in peripheral blood is 11 days after infusion
Excretion
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Dialyzable?
Unknown
REF:
PATHOLOGY SLIDES:
ENTRY UPDATES:
Marco Bonilla
Chicago/US
Sep 25, 2022