Ipilimumab Brand Name– YERVOY
What is Ipilimumab
Ipilimumab is a recombinant, human monoclonal antibody that binds to the cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and blocks the interaction of CTLA-4 with its ligands CD80/CD86.
Blockade of CTLA-4 augments T cell activation and proliferation, including tumor-infiltrating T-effector cells.
The inhibition of CTLA-4 signaling may cause a decrease in T-cell regulatory function resulting in an increase in T-cell antitumor responsiveness. Ipilimumab is produced in mammalian (Chinese hamster ovary) cell culture.
Ipilimumab is indicated for use in patients with hepatocellular cancer, malignant melanoma, renal cell carcinoma, non-small cell lung cancer (NSCLC), and microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer.
Ipilimumab may cause fatal immune-mediated adverse reactions such as enterocolitis, hepatitis, dermatitis, neuropathy, and endocrinopathy; an interruption or discontinuation of therapy may be necessary for suspected immune-mediated adverse reactions.
Indications
- colorectal cancer
- hepatocellular cancer
- malignant melanoma
- non-small cell lung cancer (NSCLC)
- renal cell cancer
For the treatment of malignant melanoma
for the adjuvant treatment of cutaneous melanoma with pathologic involvement of regional lymph nodes of more than 1 mm, in patients who have undergone complete resection, including total lymphadenectomy
Side Effects
- abdominal pain
- abdominal pain
- acne vulgaris
- acneiform rash
- acute respiratory distress syndrome (ARDS)
- adrenocortical insufficiency
- adrenocortical insufficiency
- alopecia
- anemia
- anemia
- anorexia
- anorexia
- antibody formation
- aplastic anemia
- arthralgia
- arthralgia
- arthropathy
- ascites
- asthenia
- atopic dermatitis
- atrial fibrillation
- back pain
- blepharitis
- blurred vision
- bone pain
- bullous rash
- chills
- colitis
- colitis
- conjunctivitis
- constipation
- constipation
- cough
- cough
- Cushing’s syndrome
- dehydration
- diabetes mellitus
- diarrhea
- diarrhea
- dizziness
- dizziness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dyspepsia
- dyspnea
- dyspnea
- edema
- edema
- elevated hepatic enzymes
- elevated hepatic enzymes
- encephalopathy
- enterocolitis
- enterocolitis
- eosinophilia
- erythema multiforme
- esophagitis
- exfoliative dermatitis
- fatigue
- fatigue
- fever
- fever
- gastritis
- GI perforation
- graft-versus-host disease (GVHD)
- Guillain-Barre syndrome
- headache
- headache
- hearing loss
- hemoptysis
- hepatic failure
- hepatitis
- hepatitis
- hepatitis B exacerbation
- hepatotoxicity
- hyperamylasemia
- hyperamylasemia
- hyperbilirubinemia
- hyperbilirubinemia
- hyperglycemia
- hyperglycemia
- hyperkalemia
- hyperkalemia
- hyperthyroidism
- hyperthyroidism
- hypocalcemia
- hypocalcemia
- hypoesthesia
- hypokalemia
- hypokalemia
- hypomagnesemia
- hypomagnesemia
- hyponatremia
- hyponatremia
- hypophysitis
- hypopituitarism
- hypopituitarism
- hypotension
- hypothyroidism
- hypothyroidism
- ileus
- infection
- influenza
- infusion-related reactions
- insomnia
- insomnia
- interstitial nephritis
- iritis
- leukopenia
- leukopenia
- lymphopenia
- lymphopenia
- maculopapular rash
- malaise
- meningitis
- muscle cramps
- musculoskeletal pain
- musculoskeletal pain
- myalgia
- myasthenia
- myocarditis
- nausea
- nausea
- neutropenia
- neutropenia
- ocular inflammation
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- pancreatitis
- paresthesias
- peptic ulcer
- pericarditis
- peripheral edema
- peripheral neuropathy
- pharyngitis
- pneumonitis
- pneumonitis
- pruritus
- pruritus
- psoriasis
- pulmonary embolism
- rash
- rash
- renal failure (unspecified)
- retinal detachment
- rhabdomyolysis
- rhinitis
- skin hypopigmentation
- skin ulcer
- Stevens-Johnson syndrome
- stomatitis
- synovitis
- thrombocytopenia
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- uveitis
- vasculitis
- vertigo
- Vogt-Koyanagi-Harada syndrome
- vomiting
- vomiting
- weight loss
- weight loss
- xerosis
- xerostomia
Monitoring Parameters
- LFTs
- ophthalmologic exam
- serum creatinine
- serum electrolytes
- thyroid function tests (TFTs)
Contraindications
- adrenal insufficiency
- allogeneic stem cell transplant
- autoimmune disease
- breast-feeding
- colitis
- contraception requirements
- Crohn’s disease
- diabetes mellitus
- diarrhea
- encephalopathy
- Guillain-Barre syndrome
- hepatic disease
- hepatitis
- hyperthyroidism
- hypophysitis
- hypopituitarism
- hypothyroidism
- immune-mediated reactions
- immunosuppression
- inflammatory bowel disease
- infusion-related reactions
- iritis
- mental status changes
- myasthenia gravis
- ocular disease
- organ transplant
- pancreatitis
- peripheral neuropathy
- pneumonitis
- pregnancy
- pulmonary disease
- renal disease
- renal impairment
- reproductive risk
- rheumatoid arthritis
- sarcoidosis
- serious rash
- systemic lupus erythematosus (SLE)
- thyroid disease
- type 1 diabetes mellitus
- ulcerative colitis
- uveitis
- viral infection
Interactions
- Clozapine
- Palifermin
- Penicillamine
- Tuberculin Purified Protein Derivative, PPD
- Vemurafenib