# Anetumab ravtansine

Source: https://onco.cc/drugs/anetumab-ravtansine/  
OnCo record `anetumab-ravtansine` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Anetumab ravtansine was the first antibody-drug conjugate tested in a randomised trial in mesothelioma, aimed at the mesothelin protein that nearly all mesotheliomas carry; it was no better than vinorelbine chemotherapy as second-line treatment, and is now being tried with pembrolizumab.

## Summary

Bayer built anetumab ravtansine around mesothelin, a surface protein over-expressed in mesothelioma, ovarian, pancreatic and some lung cancers but scarce in normal tissue. In the 248-patient randomised phase 2 trial in relapsed, mesothelin-positive pleural mesothelioma after platinum and pemetrexed, median progression-free survival was 4.3 months with anetumab ravtansine against 4.5 months with vinorelbine (hazard ratio 1.22), with far less neutropenia but corneal and other toxicities, so development for mesothelioma as a single agent stopped. A National Cancer Institute phase 1/2 trial is testing it with pembrolizumab, and the drug remains the reference case for why mesothelin-directed conjugates have struggled: shed mesothelin in the blood soaks up antibody, expression is heterogeneous, and a tubulin payload adds little to a slow-growing tumour that already resists chemotherapy.

## Fields

- Kind: Treatment
- Status: negative
- Last checked: 2026-09-08
- Also known as: BAY 94-9343
- Tags: gap-fill; owner-request
- Modality: Antibody-drug conjugate (anti-mesothelin antibody, DM4 payload), intravenous
- Mechanism: A fully human anti-mesothelin antibody linked through a disulfide linker to the maytansinoid tubulin inhibitor DM4; binding to mesothelin on the tumour cell surface internalises the conjugate and releases the payload.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Anetumab_ravtansine
- Kindler et al., anetumab ravtansine versus vinorelbine in relapsed mesothelin-positive mesothelioma, randomised phase 2 (Lancet Oncology 2022): https://doi.org/10.1016/S1470-2045(22)00061-4
- Hassan et al., first-in-human phase 1 of anetumab ravtansine (JCO 2020): https://doi.org/10.1200/JCO.19.02085
- Golfier et al., preclinical characterisation of BAY 94-9343 (Mol Cancer Ther 2014): https://doi.org/10.1158/1535-7163.MCT-13-0926

## Connected records

- cancers: [Mesothelioma](https://onco.cc/cancers/mesothelioma/), [Ovarian cancer](https://onco.cc/cancers/ovarian/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [Antibody-drug conjugate (ADC)](https://onco.cc/technologies/adc/)
- targets: [Mesothelin](https://onco.cc/targets/mesothelin/)
- drugs: [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/), [Vinorelbine](https://onco.cc/drugs/vinorelbine/)
- companies: [Bayer](https://onco.cc/companies/bayer/)
- trials: [Anetumab ravtansine versus vinorelbine in relapsed mesothelin-positive pleural mesothelioma](https://onco.cc/trials/anetumab-vs-vinorelbine-mpm/), [Pembrolizumab with or without anetumab ravtansine in mesothelin-positive pleural mesothelioma (NCI)](https://onco.cc/trials/nci-anetumab-pembrolizumab-mpm/)
- ideas: [Antibody-drug conjugates for mesothelioma: why they have failed so far and how they could work](https://onco.cc/ideas/idea-adc-for-mesothelioma/)

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