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Bivatuzumab (also known as BIWA 4) is a humanized monoclonal antibody directed against the variant 6 isoform of CD44 (CD44v6), a cell-surface glycoprotein overexpressed in various carcinomas, including squamous cell carcinoma of the head and neck, non-small cell lung cancer, and breast cancer. Developed by Boehringer Ingelheim, bivatuzumab was evaluated in Phase I clinical trials as a naked antibody, as well as a targeting vehicle for radioimmunotherapy when radiolabeled with isotopes such as Rhenium-186 or Technetium-99m. It also served as the antibody component of the antibody-drug conjugate bivatuzumab mertansine. Clinical development of bivatuzumab and its derivatives was halted in 2005 due to severe, dose-limiting skin toxicities, including maculopapular rashes and skin exfoliation, caused by the expression of CD44v6 on normal proliferating epidermal keratinocytes.
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