Fame and Mortality: Evidence from a Retrospective Analysis of Singers
November 26, 2025
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Brand Name :
Tivdak
(United States) [Available]Synonyms :
tisotumab vedotin
Class :
Antimicrotubular, Antineoplastics
Brand Name :
Tivdak
(United States) [Available]Synonyms :
tisotumab vedotin
Class :
Antimicrotubular, Antineoplastics
Dosage Forms & StrengthsÂ
Injection (lyophilized powder for reconstitution)Â
40 mg/vialÂ
Recommended for patients whose cervical cancer has spread to other organs or has returned after chemotherapy
2 mg/kg intravenous every three weeks; for patients ≥100 kg, not more than 200 mg/dose
Continue until the disease worsens or the toxicity becomes intolerable
Dosage Modifications:
Schedule for dose decrease
First reduced dose: 1.3 mg/kg
The second reduced dose: 0.9 mg/kg
If unable to handle 0.9 mg/kg, stop using it permanently
Keratitis
Any instance of superficial punctate keratitis (SPK): supervise Perforation or ulcerative keratitis: Immediately stop using
superficial keratitis with confluence
Initial occurrence: Delay in starting at the next lower dose until SPK or normal
Second occurrence: Stop forever
Conjunctival ulceration
Initial incidence: Delay until full conjunctival reepithelialization has occurred; then, resume at the following lower dose
Second incidence: Stop forever
scarring on the cornea or conjunctiva or symblepharon
Any symblepharon or scarring: Immediately stop using
Conjunctivitis and other ocular adverse reactions
any incidence in grade 1: monitor
Grade 2-4
First incidence in Grade 2: Delay until Grade 1 and then continue at the same dose
Grade 2, second incidence: Delay until Grade 1, restart at the subsequent lower dose, and if Grade 1 does not improve, permanently quit
Grade 2, third offence: Stop forever
Grades 3 or 4: Discontinue forever
Peripheral neuropathy
Grade 2, beginning or severity of an existing condition: Hold off until Grade 1 and resume at the following lower dose
Grades 3 or 4: Discontinue forever
Hemorrhage
Any CNS or pulmonary grade: Permanently stop
Any other place
Grade 2: Delay until issue is rectified; then, restart dose
Grade 3, initial event: Delay resume at same dose until resolved
Grade 3, second event, or grade 4: Permanently stop
Pneumonitis
For persistent or recurring pneumonitis in Grade 2, wait until Grade 1 and then think about starting again at the following lower dose
Grade 3 or 4: Discontinue forever
Renal impairment
There is no need to alter the dosage for creatinine clearance 30 to 90 ml/min
End-stage renal disease (ESRD) with or without dialysis or creatinine clearance 15–30 ml/min: Unknown pharmacokinetics
Hepatic impairment
Mild: Carefully watch for side effects; do not change the beginning dose
Moderate to severe: Do not use
Dosing consideration
Ocular examination: Do an eye examination, including slit lamp testing for visual acuity, at baseline, before each dose, and as clinically necessary
Topical corticosteroid eye drops: After examination with a slit lamp, determine the initial prescription and all renewals of any corticosteroid medication
Use topical ocular vasoconstrictor drops to each eye just prior to each infusion
Topical lubricating ophthalmic drops: Inform patients to use them throughout the course of treatment and for 30 days following the last dosage
Contact lenses: For the whole course of treatment, advise patients to refrain from wearing contact lenses unless instructed to do so by their eye doctor
Safety and efficacy not established.Â
Refer adult dosing
Actions and Spectrum:Â
It is a conjugate of monoclonal antibody and monomethyl auristatin E(MMAE) which is a cell division inhibitor that targets the tissue factor. MMAE disrupts the microtubule’s structure, which is helpful for cell division. When microtubules are damaged in rapidly dividing cells, the cell cycle stops, thereby leading to the programmed cell death.Â
Constipation Â
Hemorrhage Â
Abdominal pain  Â
Urinary tract infection Â
Pain in extremity Â
Diarrhea Â
Black Box Warning: Â
Changes, in the conjunctiva and the epithelium of cornea can lead to vision impairment and ulcers. Â
It is important to examine the eyes and follow medication procedures and adjust the dosage according to the seriousness of the condition.Â
Contraindication/Caution: Â
Caution is advised in patients suffering from Pneumonitis, peripheral neuropathy, haemorrhage and several ocular effects.Â
Pregnancy consideration:
Pregnancy category: NA
Lactation: The excretion of drug into human milk is unknown and it is not safe as well.Â
Pregnancy Categories:Â Â Â Â Â
Category A:Â Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.
Category B: There were lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.
Category C:Â there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D:Â adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X:Â Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N:Â There is no data available for the drug under this category
PharmacologyÂ
It is a cytotoxic antibody to drug combination that consists of monomethyl auristatin E, a cytotoxic agent, and an antibody. By releasing the MMAE upon cell entrance, it targets tissues on cervical tumours and may indirectly destroy nearby cells and encourage immunological cell death pathways.Â
Pharmacokinetics:Â
AbsorptionÂ
The peak plasma concentration is 40.8mcg/mlÂ
Area under the curve:57.5mcg/mlÂ
DistributionÂ
Volume of the Distribution:7.83LÂ
Rate of plasma protein binding:68% to 82%Â
MetabolismÂ
Catabolism breaks down isotumab vedotin into smaller molecules: amino acids, short protein chains, unlinked MMAE, and byproducts linked to unlinked MMAE.Â
Elimination/ExcretionÂ
Elimination half-life:4 daysÂ
Clearance:1.54L/dayÂ
Rate of Excretion:17% through feces;6% through urineÂ
AdministrationÂ
It is administered through intravenous infusion for 30 minutes.Â
Patient information leaflet:Â Â
Generic Name: tisotumab vedotinÂ
Why do we use tisotumab vedotin?Â
It is drug and antibody conjugate which contains drug that kills cancer and monoclonal antibody. It is used to treat patients suffering from recurrent or metastatic cervical cancer who have undergone chemotherapy.Â
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