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D2C7-(scdsFv)-PE38KDEL is a recombinant dual-specific immunotoxin designed for the treatment of malignant gliomas, specifically glioblastoma multiforme (GBM). It consists of a single-chain disulfide-stabilized fragment variable (scdsFv) of the D2C7 monoclonal antibody, which targets both the wild-type epidermal growth factor receptor (EGFR) and the tumor-specific EGFR variant III (EGFRvIII) mutation. The antibody fragment is fused to a 38 kDa truncated portion of Pseudomonas exotoxin A (PE38) and a C-terminal KDEL endoplasmic reticulum (ER) retention signal. After binding to EGFR or EGFRvIII on the cell surface, the immunotoxin is internalized via endocytosis. The PE38 moiety is then cleaved and transported to the ER and subsequently the cytosol, where it catalyzes the ADP-ribosylation of elongation factor 2 (EF-2), halting protein synthesis and inducing apoptosis in the target cancer cells. This agent is typically delivered via convection-enhanced delivery (CED) to bypass the blood-brain barrier.
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