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LMB-7 is a single-chain immunotoxin constructed from the murine monoclonal antibody B3 and a truncated form of Pseudomonas exotoxin (PE38). It targets a carbohydrate epitope (LeY antigen) found on solid tumors that frequently invade the intrathecal space and cause neoplastic meningitis. The immunotoxin works by binding to cancer cells, becoming internalized, and delivering the toxin to the cytosol where it inhibits protein synthesis by inactivating eukaryotic elongation factor 2 (eEF2), ultimately leading to cell death. LMB-7 showed significant efficacy in preclinical rat models of carcinomatous meningitis but demonstrated unexpectedly low activity in subsequent clinical trials.
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