dinutuximab beta at a glance
Medicine class
Antineoplastic monoclonal antibody targeting GD2
Main use
Selected high-risk, relapsed or refractory neuroblastoma in patients aged 12 months and over
Administration
Intravenous infusion under specialist supervision
Supportive care
Pain relief and antihistamine premedication are important because pain and infusion reactions are common
What is dinutuximab beta used for?
Licensed uses include:
High-risk neuroblastoma in patients aged 12 months and over who achieved at least a partial response to induction chemotherapy and then received myeloablative therapy and stem-cell transplantation.
Relapsed or refractory neuroblastoma, with or without residual disease; actively progressing relapsed disease should first be stabilised by other suitable measures.
Combination with interleukin-2 for relapsed or refractory disease and when a complete response was not achieved after first-line therapy.
How does dinutuximab beta work?
Dinutuximab beta binds GD2, which is found at high levels on neuroblastoma cells, and marks them for immune destruction. GD2 is also present on peripheral nerves, helping to explain neuropathic pain and neurological adverse effects.
How to take dinutuximab beta
A specialist healthcare professional dilutes dinutuximab beta and gives it into a vein using a catheter and infusion pump. Facilities to treat severe reactions must be immediately available.
Pain relief is prepared before treatment and adjusted according to symptoms.
An antihistamine is given before infusion.
Monitoring covers allergic reactions, blood-pressure changes, breathing problems, pain and neurological effects.
Do not drive or operate machinery during treatment.
dinutuximab beta side effects
Common or expected effects
- Pain, including abdominal, limb, back, chest, joint or muscle pain
- Fever and chills
- Infusion or hypersensitivity reactions, including rash, itching, hives and low blood pressure
- Vomiting, diarrhoea or constipation
- Anaemia, low white-cell counts or low platelets
- Fluid retention, swelling or increased weight
- Cough, low oxygen levels or fast heartbeat
- Headache or altered pupil responses
- Infections, including venous-catheter infections
Get urgent medical advice
- Severe allergic reaction or cytokine-release syndrome
- Capillary leak syndrome causing rapid swelling, low blood pressure, dizziness or breathing difficulty
- Sepsis or another severe infection
- Seizures, confusion, altered consciousness, persistent headache or major weakness
- New blurred vision, light sensitivity, abnormal eye movement or loss of vision
- Severe peripheral neuropathy
- Heart failure, respiratory failure or fluid in the lungs
- Kidney failure or markedly reduced urine
- Atypical haemolytic uraemic syndrome, potentially causing anaemia, bruising or bleeding and kidney injury
dinutuximab beta in pregnancy
Dinutuximab beta should not be used during pregnancy because it may cross the placenta and harm developing nervous tissue. Discuss pregnancy testing and effective contraception with the specialist team; contraception is recommended for six months after treatment ends.
dinutuximab beta while breastfeeding
It is unknown whether dinutuximab beta passes into human milk. Breastfeeding should stop during treatment and for six months after the last administration.
dinutuximab beta interactions
Formal interaction studies have not been performed. The specialist team should review all medicines and vaccinations.
Systemic corticosteroids and other immunosuppressants
Immunosuppression could oppose treatment. Concomitant corticosteroids are not recommended around therapy unless required for a life-threatening condition.
Vaccines
Avoid during treatment and until ten weeks after the final treatment course because of immune stimulation and possible rare neurological toxicity.
Intravenous immunoglobulin
Concomitant use is not recommended because it may interfere with dinutuximab beta-dependent cellular killing.
Common questions about dinutuximab beta
Answers are fully visible for fast scanning and source review.
Is dinutuximab beta chemotherapy?
No. It is an immunotherapy that marks GD2-expressing neuroblastoma cells for immune attack.
Why is pain relief needed?
Binding to GD2 on peripheral nerve fibres can cause substantial neuropathic pain, so preventive and responsive pain relief is required.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.