{{Chembox | Verifiedfields = changed | Watchedfields = changed | verifiedrevid = 458641272 | ImageFile = Monomethylauristatin E.svg | ImageClass = skin-invert-image | ImageSize = 250px | ImageAlt = | IUPACName = (''S'')-''N''-((3''R'',4''S'',5''S'')-1-((''S'')-2-((1''R'',2''R'')-3-(((1''S'',2''R'')-1-hydroxy-1-phenylpropan-2-yl)amino)-1-methoxy-2-methyl-3-oxopropyl)pyrrolidin-1-yl)-3-methoxy-5-methyl-1-oxoheptan-4-yl)-''N'',3-dimethyl-2-((''S'')-3-methyl-2-(methylamino)butanamido)butanamide | OtherNames = Monomethylauristatin E | Section1 = {{Chembox Identifiers | Abbreviations = MMAE | CASNo = 474645-27-7 | CASNo_Ref = {{cascite|correct|CAS}} | UNII_Ref = {{fdacite|correct|FDA}} | UNII = V7I58RC5EJ | PubChem = 11542188 | ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} | ChemSpiderID = 9716967 | KEGG = D09691 | InChI = 1/C39H67N5O7/c1-13-25(6)34(43(10)39(49)33(24(4)5)42-38(48)32(40-9)23(2)3)30(50-11)22-31(45)44-21-17-20-29(44)36(51-12)26(7)37(47)41-27(8)35(46)28-18-15-14-16-19-28/h14-16,18-19,23-27,29-30,32-36,40,46H,13,17,20-22H2,1-12H3,(H,41,47)(H,42,48)/t25-,26+,27+,29-,30+,32-,33-,34-,35+,36+/m0/s1 | InChIKey = DASWEROEPLKSEI-UIJRFTGLBD | StdInChI_Ref = {{stdinchicite|changed|chemspider}} | StdInChI = 1S/C39H67N5O7/c1-13-25(6)34(43(10)39(49)33(24(4)5)42-38(48)32(40-9)23(2)3)30(50-11)22-31(45)44-21-17-20-29(44)36(51-12)26(7)37(47)41-27(8)35(46)28-18-15-14-16-19-28/h14-16,18-19,23-27,29-30,32-36,40,46H,13,17,20-22H2,1-12H3,(H,41,47)(H,42,48)/t25-,26+,27+,29-,30+,32-,33-,34-,35+,36+/m0/s1 | StdInChIKey_Ref = {{stdinchicite|changed|chemspider}} | StdInChIKey = DASWEROEPLKSEI-UIJRFTGLSA-N | SMILES = CO[C@H]([C@H](C(N[C@@H]([C@H](C1=CC=CC=C1)O)C)=O)C)[C@@]2([H])N(C(C[C@H]([C@H]([C@H](CC)C)N(C)C([C@H](C(C)C)NC([C@@H](NC)C(C)C)=O)=O)OC)=O)CCC2}} | Section2 = {{Chembox Properties | C=39 | H=67 | N=5 | O=7 | Appearance = | Density = | MeltingPt = | BoilingPt = | Solubility = }} | Section3 = {{Chembox Hazards | MainHazards = | FlashPt = | AutoignitionPt = }} }}
'''Monomethyl auristatin E''' ('''MMAE''') is a synthetic antineoplastic agent. Because of its toxicity, it cannot be used as a drug itself; instead, it is linked to a monoclonal antibody (MAB) which directs it to the cancer cells. In International Nonproprietary Names for MMAE-MAB-conjugates, the name '''vedotin''' refers to MMAE plus its linking structure to the antibody.<ref>[http://www.ama-assn.org/resources/doc/usan/vedotin.pdf Statement on a nonproprietary name adopted by the USAN Council: Vedotin]</ref> It is a potent antimitotic drug derived from peptides occurring in marine shell-less mollusc ''Dolabella auricularia'' called dolastatins which show potent activity in preclinical studies, both ''in vitro'' and ''in vivo'', against a range of lymphomas, leukemia and solid tumors. These drugs show potency of up to 200 times that of vinblastine, another antimitotic drug used for Hodgkin lymphoma as well as other types of cancer.<ref name="Dosio">{{Cite journal | doi = 10.3390/toxins3070848| pmid = 22069744| title = Immunotoxins and Anticancer Drug Conjugate Assemblies: The Role of the Linkage between Components| journal = Toxins| volume = 3| issue = 12| pages = 848–883| year = 2011| last1 = Dosio | first1 = F. | last2 = Brusa | first2 = P. | last3 = Cattel | first3 = L. | pmc = 3202854| doi-access = free}}</ref>
MMAE is actually desmethyl-auristatin E; that is, the N-terminal amino group has only one methyl substituent instead of two as in auristatin E itself.<ref name="Dosio" />
==Mechanism of action== Monomethyl auristatin E is an antimitotic agent which inhibits cell division by blocking the polymerisation of tubulin. The linker to the monoclonal antibody is stable in extracellular fluid, but is cleaved by cathepsin once the conjugate has entered a tumor cell, thus activating the antimitotic mechanism.<ref name="seagen">[http://www.seagen.com/clinical_trials_sgn35.shtml Seattle Genetics: Brentuximab vedotin (SGN-35)] {{webarchive|url=https://web.archive.org/web/20110716024457/http://www.seagen.com/clinical_trials_sgn35.shtml |date=2011-07-16 }}</ref><ref name="Francisco">{{cite journal |last=Francisco |first=Joseph A |display-authors=etal |date=2003 |title=cAC10-vcMMAE, an anti-CD30–monomethyl auristatin E conjugate with potent and selective antitumor activity |journal=Blood |volume=102 |issue=4 |pages=1458–1465 |doi=10.1182/blood-2003-01-0039 |pmid=12714494 |s2cid=25746938|doi-access=free }}</ref>
:[[File:MMAE-MAB-conjugate skeletal.svg|thumb|left|600px|Structure of a MMAE-MAB-conjugate. The linker, consisting of the amino acids valine (Val) and citrulline (Cit), is cleaved by cathepsin inside tumour cells.<ref name="Klement">{{cite journal| author = A. Klement| date = 13 May 2013| title = Sprunginnovation beim Hodgkin-Lymphom: Adcetris| journal = Österreichische Apothekerzeitung| issue = 10/2013| page = 67f| language = German}}</ref> The spacer (''para''-aminobenzylcarbamate) is marked green, the cathepsin-cleavable linker is blue, and the attachment group (consisting of maleimide and caproic acid) is brown. The whole radical inside the four boxes is called ''vedotin''.]] {{clear-left}}
==Monoclonal antibodies/ADCs== MMAE has been tested with various monoclonal antibodies (usually forming an antibody-drug conjugate). *targeting the protein CD30 which is found on malignant cells in anaplastic large cell lymphoma and Hodgkin's lymphoma: **Brentuximab (cAC10), 3–5 units of MMAE per molecule<ref name="seagen" /><ref name="Francisco" /> *targeting the glycoprotein GPNMB which is found in aggressive melanoma, glioma, breast cancer and other tumours: **Glembatumumab (CR011, CDX-011), investigated for the treatment of breast cancer and melanoma<ref>[http://www.medicalnewstoday.com/articles/154376.php Medical News Today: CuraGen Announces Expansion Of CR011-vcMMAE Phase II Trial In Advanced Breast Cancer]</ref><ref>NCI Drug Dictionary: [http://www.cancer.gov/drugdictionary/?CdrID=599456 Glembatumumab vedotin]</ref> * targeting CD37: ** AGS67E, to treat lymphoid malignancy<ref>{{cite journal | pmid = 25934707 | doi=10.1158/1535-7163.MCT-15-0067 | volume=14 | issue=7 | title=AGS67E, an Anti-CD37 Monomethyl Auristatin E Antibody-Drug Conjugate as a Potential Therapeutic for B/T-Cell Malignancies and AML: A New Role for CD37 in AML | pmc=4557793 | journal=Mol Cancer Ther | pages=1650–60 | last1 = Pereira | first1 = DS | last2 = Guevara | first2 = CI | last3 = Jin | first3 = L | last4 = Mbong | first4 = N | last5 = Verlinsky | first5 = A | last6 = Hsu | first6 = SJ | last7 = Aviña | first7 = H | last8 = Karki | first8 = S | last9 = Abad | first9 = JD | last10 = Yang | first10 = P | last11 = Moon | first11 = SJ | last12 = Malik | first12 = F | last13 = Choi | first13 = MY | last14 = An | first14 = Z | last15 = Morrison | first15 = K | last16 = Challita-Eid | first16 = PM | last17 = Doñate | first17 = F | last18 = Joseph | first18 = IB | last19 = Kipps | first19 = TJ | last20 = Dick | first20 = JE | last21 = Stover | first21 = DR| year=2015 }}</ref><ref>[https://clinicaltrials.gov/ct2/show/NCT02175433 A study of Escalating Doses of AGS67E Given as Monotherapy in Subjects With Refractory or Relapsed Lymphoid Malignancies]</ref> * targeting tissue factor in recurrent or persistent cervical cancers that progress on or after first line chemotherapy regimens: ** tisotumab vedotin<ref>{{Cite journal|last1=Coleman|first1=Robert L|last2=Lorusso|first2=Domenica|last3=Gennigens|first3=Christine|last4=González-Martín|first4=Antonio|last5=Randall|first5=Leslie|last6=Cibula|first6=David|last7=Lund|first7=Bente|last8=Woelber|first8=Linn|last9=Pignata|first9=Sandro|last10=Forget|first10=Frederic|last11=Redondo|first11=Andrés|date=May 2021|title=Efficacy and safety of tisotumab vedotin in previously treated recurrent or metastatic cervical cancer (innovaTV 204/GOG-3023/ENGOT-cx6): a multicentre, open-label, single-arm, phase 2 study|url=https://linkinghub.elsevier.com/retrieve/pii/S1470204521000565|journal=The Lancet Oncology|language=en|volume=22|issue=5|pages=609–619|doi=10.1016/S1470-2045(21)00056-5|pmid=33845034 |s2cid=233223114 |url-access=subscription}}</ref>
Examples: * Sofituzumab vedotin * Polatuzumab vedotin (RG7596) * Enfortumab vedotin * Pinatuzumab vedotin * Lifastuzumab vedotin * Brentuximab vedotin * Glembatumumab vedotin * Tisotumab vedotin * Indusatumab vedotin (MLN-0264) in phase II trials<ref>[http://adcreview.com/indusatumab-vedotin-mln-0264-clinical-trials/ Indusatumab vedotin (MLN-0264) Clinical Trials. March 2015]</ref>
==See also== * Seattle Genetics * Monomethyl auristatin F
==References== {{reflist}}
Category:Mitotic inhibitors