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This information is about a treatment for cancer called ADEPT (Antibody-Directed Enzyme Prodrug Therapy), which is in development. It aims to give a balanced summary of the information available so far. You will see your doctor regularly while you have this treatment so they can monitor its effects.
ADEPT is a new type of cancer treatment that uses drugs called monoclonal antibodies|. At the moment, ADEPT is only being used in clinical trials. The trials aim to find out whether ADEPT may be useful as a new type of treatment for bowel cancer|.
When a drug is being developed, it has to go through various stages of research called clinical trials| or studies. These aim to establish:
The trials also find out:
Many drugs that are thought to be promising may be found not to be as good as existing treatments or to have side effects that outweigh any benefits. For this reason, doctors and other medical staff carry out frequent and careful checks on the progress of everyone who is taking one of these developmental drugs. If you are having a developmental drug, your doctor will explain all about the drug, the procedures being used and how you will be looked after while you are taking it. If you have concerns at any time, you should ask your doctor or nurse for information and advice.
Monoclonal antibodies are used to try to destroy the cancer cells while causing little harm to normal cells. They recognise the protein on the surface of the cancer cell and lock on to it. Some monoclonal antibodies can then trigger the body’s immune system to attack the cancer cells and can also cause the cells to destroy themselves.
Sometimes, when used in cancer treatment, monoclonal antibodies have a cancer drug or radioactive substance attached to them. They can be used in this way to deliver treatment directly to the cancer cell. This is known as targeted therapy.
ADEPT is a type of targeted therapy. It uses a monoclonal antibody to carry an enzyme directly to the cancer cells. Enzymes are proteins that control chemical reactions in the body. First, the monoclonal antibody is given (with the enzyme attached). A few hours later, a second drug (the prodrug) is given.
When the prodrug comes into contact with the enzyme, a reaction takes place. This reaction activates the prodrug and it's then able to destroy the cancer cells. As the enzyme does not attach to normal cells, this treatment does not affect them.
ADEPT is a colourless fluid.
ADEPT is given by a drip (infusion) through a small tube (cannula) inserted into a vein. The monoclonal antibody and the prodrug are usually given in two separate doses on the same day.
Trials are looking at the side effects that may occur. As ADEPT is still a relatively new treatment, it's too early to know all of the possible side effects. However, the following appear to be the most common:
These may include a high temperature and chills, headaches, itching, and joint and muscle aches.These may occur a few hours after the treatment is given, but don't last for more than a day or two.
Signs of an allergic reaction include skin rashes and itching, high temperatures, shivering, redness of the face, dizziness, a headache, breathlessness|, anxiety and a need to pass urine. You'll be monitored for any sign of an allergic reaction during your treatment. Tell your doctor or nurse if you have any of these signs. Before you have your treatment you'll be given medication to reduce the chances of an allergic reaction.
There may be a temporary reduction in the number of your white blood cells a few days after the treatment is given. If this happens, you're more likely to get an infection| during this period. Your doctor or nurse will advise you about this and any precautions that you should take. Your white blood cells usually recover in 3–4 weeks.
This may begin a few hours after ADEPT has been given and may last for a few days. Your doctor can prescribe anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea and vomiting|. If the sickness isn't controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they're not mentioned above.
This information has been compiled using information from a number of reliable sources including:
Content last reviewed: 1 December 2010
Next planned review: 2013
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© Macmillan Cancer Support 2013
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