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Pivekimab is a humanized monoclonal antibody directed against CD123, also known as the interleukin-3 receptor alpha chain (IL-3Rα). CD123 is a cell surface protein that is highly expressed on malignant cells in various hematological cancers, including acute myeloid leukemia (AML) and blastic plasmacytoid dendritic cell neoplasm (BPDCN), while showing minimal expression on normal hematopoietic stem cells. Pivekimab serves as the targeting component of the antibody-drug conjugate (ADC) pivekimab sunirine (IMGN632), where it is linked to an indolinobenzodiazepine pseudodimer (IGN) DNA-alkylating payload. Beyond its role in the ADC, pivekimab is being investigated as a scaffold for radiotheranostics, such as 89Zr-labeled versions for immuno-positron emission tomography (immunoPET) imaging and 177Lu-labeled versions for radioimmunotherapy (RIT), to enable the noninvasive assessment of target expression and the targeted delivery of beta-particle radiation to CD123-positive tumors.
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