{"entity":{"id":"anetumab-ravtansine","kind":"drug","name":"Anetumab ravtansine","aka":["BAY 94-9343"],"tldr":"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.","status":"negative","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Anetumab_ravtansine","links":[{"label":"Kindler et al., anetumab ravtansine versus vinorelbine in relapsed mesothelin-positive mesothelioma, randomised phase 2 (Lancet Oncology 2022)","url":"https://doi.org/10.1016/S1470-2045(22)00061-4"},{"label":"Hassan et al., first-in-human phase 1 of anetumab ravtansine (JCO 2020)","url":"https://doi.org/10.1200/JCO.19.02085"},{"label":"Golfier et al., preclinical characterisation of BAY 94-9343 (Mol Cancer Ther 2014)","url":"https://doi.org/10.1158/1535-7163.MCT-13-0926"}],"tags":["gap-fill","owner-request"],"related":[],"cancers":["mesothelioma","ovarian","pancreatic"],"sections":[],"technologies":["adc"],"targets":["mesothelin"],"drugs":["vinorelbine","pembrolizumab"],"companies":["bayer"],"institutions":[],"pathways":[],"terms":[],"trials":["anetumab-vs-vinorelbine-mpm","nci-anetumab-pembrolizumab-mpm"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"notes":[],"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.","approvals":[],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/anetumab-ravtansine/","neighbours":{"cancer":[{"id":"mesothelioma","kind":"cancer","name":"Mesothelioma","route":"/cancers/mesothelioma/"},{"id":"ovarian","kind":"cancer","name":"Ovarian cancer","route":"/cancers/ovarian/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"adc","kind":"technology","name":"Antibody-drug conjugate (ADC)","route":"/technologies/adc/"}],"target":[{"id":"mesothelin","kind":"target","name":"Mesothelin","route":"/targets/mesothelin/"}],"drug":[{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"},{"id":"vinorelbine","kind":"drug","name":"Vinorelbine","route":"/drugs/vinorelbine/"}],"company":[{"id":"bayer","kind":"company","name":"Bayer","route":"/companies/bayer/"}],"trial":[{"id":"anetumab-vs-vinorelbine-mpm","kind":"trial","name":"Anetumab ravtansine versus vinorelbine in relapsed mesothelin-positive pleural mesothelioma","route":"/trials/anetumab-vs-vinorelbine-mpm/"},{"id":"nci-anetumab-pembrolizumab-mpm","kind":"trial","name":"Pembrolizumab with or without anetumab ravtansine in mesothelin-positive pleural mesothelioma (NCI)","route":"/trials/nci-anetumab-pembrolizumab-mpm/"}],"idea":[{"id":"idea-adc-for-mesothelioma","kind":"idea","name":"Antibody-drug conjugates for mesothelioma: why they have failed so far and how they could work","route":"/ideas/idea-adc-for-mesothelioma/"}]}}