Palifermin

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Palifermin Brand Name– Kepivance

What is Palifermin

Palifermin is a recombinant human keratinocyte growth factor (KGF) that binds to KGF receptors in certain tissues resulting in proliferation, differentiation, and migration of epithelial cells. KGF receptors are located in tissues of the tongue, buccal mucosa, esophagus, stomach, intestine, and salivary glands.

The incidence and duration of WHO grade 3 or 4 mucositis was significantly lower with palifermin therapy compared with placebo in patients with hematologic cancers who received myelosuppressive conditioning therapy prior to an autologous hematopoietic stem-cell transplantation (HSCT) in a randomized, double-blind, phase III trial (n = 212).

In December 2004, palifermin was approved by the FDA to decrease the incidence and duration of severe oral mucositis in patients with hematologic malignancies receiving myelotoxic therapy requiring hematopoietic stem cell support. In July 2016, palifermin is approved for use as supportive care in patients with hematologic malignancies who are receiving a myelotoxic preparative regimen followed by an autologous HSCT that is predicted to result in a high incidence of WHO Grade 3 or higher mucositis.

Palifermin is not recommended for use in patients with nonhematologic malignancies, in patients receiving an allogeneic stem-cell transplantation, or in combination with melphalan 200 mg/m2 as a conditioning regimen.

Indications

  • mucositis prophylaxis

For mucositis prophylaxis

Palifermin was not effective in decreasing the incidence of severe mucositis in patients with hematologic malignancies receiving myelotoxic therapy in the setting of allogeneic hematopoietic stem cell support.

Side Effects

  1. antibody formation
  2. arthralgia
  3. cataracts
  4. dysesthesia
  5. dysgeusia
  6. edema
  7. erythema
  8. fever
  9. hyperamylasemia
  10. hyperamylasemia
  11. hyperesthesia
  12. hypertension
  13. hypoesthesia
  14. infection
  15. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  16. paresthesias
  17. pruritus
  18. rash
  19. rash
  20. tongue discoloration

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • breast-feeding
  • infertility
  • non-hematologic malignancy
  • pregnancy

Interactions

  • Ado-Trastuzumab emtansine
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Altretamine
  • Antineoplastic Agents
  • Ardeparin
  • Arsenic Trioxide
  • Atezolizumab
  • Avelumab
  • Azacitidine
  • Belinostat
  • Bendamustine
  • Bevacizumab
  • Bexarotene
  • Bleomycin
  • Blinatumomab
  • Brentuximab vedotin
  • Busulfan
  • Cabazitaxel
  • Calaspargase pegol
  • Capecitabine
  • Carboplatin
  • Carmustine, BCNU
  • Cemiplimab
  • Cetuximab
  • Chlorambucil
  • Cisplatin
  • Cladribine
  • Clofarabine
  • Cyclophosphamide
  • Cytarabine, ARA-C
  • Dacarbazine, DTIC
  • Dactinomycin, Actinomycin D
  • Dalteparin
  • Daratumumab
  • Daratumumab; Hyaluronidase
  • Daunorubicin
  • Daunorubicin Liposomal
  • Daunorubicin Liposomal; Cytarabine Liposomal
  • Decitabine
  • Denileukin Diftitox
  • Denosumab
  • Dinutuximab
  • Docetaxel
  • Doxorubicin
  • Doxorubicin Liposomal
  • Durvalumab
  • Elotuzumab
  • Enoxaparin
  • Epirubicin
  • Eribulin
  • Estramustine
  • Etoposide, VP-16
  • Everolimus
  • Floxuridine
  • Fludarabine
  • Fluorouracil, 5-FU
  • Gemcitabine
  • Gemtuzumab Ozogamicin
  • Heparin
  • Hydroxyurea
  • Ibritumomab Tiuxetan
  • Idarubicin
  • Ifosfamide
  • Inotuzumab Ozogamicin
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Iobenguane I 131
  • Ipilimumab
  • Irinotecan
  • Irinotecan Liposomal
  • Ixabepilone
  • L-Asparaginase Escherichia coli
  • Lomustine, CCNU
  • Low Molecular Weight Heparins
  • Lutetium Lu 177 dotatate
  • Mechlorethamine, Nitrogen Mustard
  • Melphalan
  • Mercaptopurine, 6-MP
  • Methotrexate
  • Methoxsalen
  • Midostaurin
  • Mitomycin
  • Mitotane
  • Mitoxantrone
  • Mogamulizumab
  • Moxetumomab pasudotox
  • Nanoparticle Albumin-Bound Paclitaxel
  • Necitumumab
  • Nelarabine
  • Nivolumab
  • Obinutuzumab
  • Ofatumumab
  • Olaratumab
  • Omacetaxine
  • Oxaliplatin
  • Paclitaxel
  • Panitumumab
  • Panobinostat
  • Pegaspargase
  • Pembrolizumab
  • Pemetrexed
  • Pentostatin
  • Pertuzumab
  • Plicamycin
  • Porfimer
  • Pralatrexate
  • Procarbazine
  • Ramucirumab
  • Rituximab
  • Rituximab; Hyaluronidase
  • Romidepsin
  • Streptozocin
  • Tagraxofusp
  • Talimogene Laherparepvec
  • Temozolomide
  • Temsirolimus
  • Teniposide
  • Thioguanine, 6-TG
  • Thiotepa
  • Tinzaparin
  • Topotecan
  • Tositumomab
  • Trabectedin
  • Trastuzumab
  • Trastuzumab; Hyaluronidase
  • Tretinoin, ATRA
  • Trifluridine; Tipiracil
  • Venetoclax
  • Vinblastine
  • Vincristine
  • Vincristine Liposomal
  • Vinorelbine
  • Vorinostat
  • Ziv-Aflibercept

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