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# Tebentafusp
## Overview
Tebentafusp is a bispecific C-type lectin-like protein 1 (CLECT1)- and CD3-directed protein therapy. It binds to CLECT1 expressed on tumor cells and to CD3 on T-cells, bringing them into close proximity to facilitate T-cell-mediated tumor cell killing.
## Primary Indications
Unresectable or metastatic uveal melanoma in adults.
## Adult Dosing
The recommended dose is 20 mcg/kg intravenously on day 1, followed by 10 mcg/kg intravenously on day 8, and then 10 mcg/kg intravenously every 2 weeks thereafter.
## Pediatric Dosing
There is no established pediatric dosing for tebentafusp.
## Dose Adjustments
Dosing adjustments may be required based on the severity of adverse reactions, particularly immune-related toxicities. Refer to the full prescribing information for detailed dose modification guidelines.
## Contraindications
* Hypersensitivity to any component of the formulation.
* Conditions where the immune system is overly active, such as recent or ongoing inflammatory disorders (e.g., active hepatitis, pneumonitis, colitis, hypophysitis).
## Adverse Effects
Common adverse effects include rash, pyrexia, fatigue, edema, nausea, chills, abdominal pain, musculoskeletal pain, and hypertension. Serious adverse effects can include cytokine release syndrome (CRS), immune-related toxicities (e.g., hepatitis, pneumonitis, colitis, hypophysitis, thyroiditis, nephritis), and ocular toxicity.
## Key Drug Interactions
* Immunosuppressants: Concomitant use may reduce the efficacy of tebentafusp.
* Corticosteroids: Systemic corticosteroids are generally not recommended for the management of CRS or immune-related toxicities unless clinically indicated.
## Monitoring
* Monitor for signs and symptoms of CRS and immune-related toxicities, including ocular toxicity.
* Monitor liver function tests, renal function, thyroid function, and electrolytes.
* Ophthalmologic examinations are recommended prior to and during treatment.
## Clinical Pearls
Tebentafusp is associated with a significant risk of CRS and immune-related toxicities. Educate patients on the signs and symptoms and the importance of prompt reporting. Premedication with corticosteroids is generally not recommended for CRS prevention.
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**Disclaimer:** This information is intended for healthcare professionals and is based on currently available data. It is essential to consult the most current prescribing information and local guidelines for definitive patient care decisions.
