What is Temsirolimus
Temsirolimus, an ester analog of sirolimus, is an inhibitor of mammalian target of rapamycin (mTOR) and was the first FDA-approved mTOR antagonist for the treatment of renal cell cancer (RCC).
Treatment with temsirolimus significantly improved overall survival and progression-free survival compared with interferon alfa in patients with previously untreated advanced RCC (clear cell and non-clear cell histologies). Exposure to temsirolimus increases significantly with hepatic impairment.
Significant hypersensitivity / infusion-related reactions have been reported with temsirolimus administration; premedication with an antihistamine is recommended.
Additionally temsirolimus can cause significant immunosuppression. Live vaccines should be avoided, and patients should be closely monitored for infection.
Brand Name
Torisel
Indications
- glioblastoma multiforme
- malignant glioma
- mantle cell lymphoma (MCL)
- neuroblastoma
- renal cell cancer
- rhabdomyosarcoma
For the treatment of advanced renal cell cancer
Side Effects
- abdominal pain
- acne vulgaris
- anaphylactic shock
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- apnea
- arthralgia
- asthenia
- back pain
- chest pain (unspecified)
- chills
- cholecystitis
- cholelithiasis
- conjunctivitis
- constipation
- cough
- depression
- diabetes mellitus
- diarrhea
- dysgeusia
- dyspnea
- edema
- elevated hepatic enzymes
- epistaxis
- exfoliative dermatitis
- fever
- flushing
- GI bleeding
- GI perforation
- glossitis
- headache
- hyperbilirubinemia
- hypercholesterolemia
- hyperglycemia
- hyperlipidemia
- hypertension
- hypertriglyceridemia
- hypokalemia
- hypophosphatemia
- hypotension
- hypoxia
- immunosuppression
- impaired wound healing
- increased urinary frequency
- infection
- infusion-related reactions
- injection site reaction
- insomnia
- leukopenia
- lymphopenia
- maculopapular rash
- metabolic acidosis
- myalgia
- nausea
- nephrotic syndrome
- neutropenia
- oral ulceration
- pancreatitis
- pericardial effusion
- peripheral edema
- pharyngitis
- phlebitis
- pleural effusion
- pneumonitis
- proteinuria
- pruritus
- psychosis
- pulmonary embolism
- rash
- renal failure (unspecified)
- rhabdomyolysis
- rhinitis
- seizures
- Stevens-Johnson syndrome
- stomatitis
- thrombocytopenia
- thromboembolism
- thrombosis
- vomiting
- weight loss
- xerosis
Monitoring Parameters
- blood glucose
- CBC with differential
- chest x-ray
- LFTs
- serum cholesterol
- serum creatinine/BUN
- serum triglycerides
- urinalysis
Contraindications
- anticoagulant therapy
- brain tumor
- breast-feeding
- children
- contraception requirements
- coronary artery disease
- corticosteroid therapy
- diabetes mellitus
- geriatric
- GI perforation
- hepatic disease
- hypercholesterolemia
- hyperlipidemia
- hypertriglyceridemia
- immunosuppression
- infants
- infection
- male-mediated teratogenicity
- neonates
- pneumonitis
- polysorbate 80 hypersensitivity
- pregnancy
- proteinuria
- pulmonary disease
- reproductive risk
- surgery
- vaccination
Interactions
- Abacavir; Dolutegravir; Lamivudine
- Afatinib
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Amiodarone
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Apalutamide
- Atazanavir
- Atazanavir; Cobicistat
- Atorvastatin
- Atorvastatin; Ezetimibe
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benazepril
- Benazepril; Hydrochlorothiazide, HCTZ
- Betrixaban
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Brigatinib
- Budesonide
- Budesonide; Formoterol
- Cabozantinib
- Capmatinib
- Captopril
- Captopril; Hydrochlorothiazide, HCTZ
- Carbamazepine
- Carvedilol
- Ceritinib
- Chloramphenicol
- Clarithromycin
- Clevidipine
- Cobicistat
- Cobimetinib
- Colchicine
- Colchicine; Probenecid
- Conivaptan
- Cyclosporine
- Dabigatran
- Daclatasvir
- Dapagliflozin; Saxagliptin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Dexamethasone
- Dextromethorphan; Quinidine
- Digoxin
- Diltiazem
- Dolutegravir
- Dolutegravir; Lamivudine
- Dolutegravir; Rilpivirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxorubicin
- Dronedarone
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Edoxaban
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Emtricitabine; Tenofovir disoproxil fumarate
- Enalapril, Enalaprilat
- Enalapril; Felodipine
- Enalapril; Hydrochlorothiazide, HCTZ
- Enzalutamide
- Erythromycin
- Erythromycin; Sulfisoxazole
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etravirine
- Felodipine
- Flibanserin
- Fluticasone; Umeclidinium; Vilanterol
- Fosamprenavir
- Fosinopril
- Fosinopril; Hydrochlorothiazide, HCTZ
- Fosphenytoin
- Fostamatinib
- Glecaprevir; Pibrentasvir
- Glyburide
- Glyburide; Metformin
- grapefruit juice
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Quinapril
- Ibrutinib
- Idelalisib
- Indinavir
- Irinotecan
- Irinotecan Liposomal
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isradipine
- Istradefylline
- Itraconazole
- Ivacaftor
- Ketoconazole
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lapatinib
- Ledipasvir; Sofosbuvir
- Lefamulin
- Letermovir
- Lisinopril
- Live Vaccines
- Lomitapide
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Maraviroc
- Mefloquine
- Mephobarbital
- Metformin; Saxagliptin
- Mifepristone
- Mitomycin
- Mitotane
- Modafinil
- Moexipril
- Morphine
- Morphine; Naltrexone
- Naldemedine
- Nefazodone
- Nelfinavir
- Neratinib
- Nicardipine
- Nifedipine
- Nimodipine
- Nisoldipine
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Osimertinib
- Palifermin
- Penicillamine
- Perindopril
- Perindopril; Amlodipine
- Phenobarbital
- Phenytoin
- Ponatinib
- Posaconazole
- Primidone
- Propafenone
- Quinapril
- Quinidine
- Quinine
- Ramipril
- Ranolazine
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifaximin
- Rimegepant
- Riociguat
- Risperidone
- Ritonavir
- Rolapitant
- Romidepsin
- Sapropterin
- Saquinavir
- Saxagliptin
- Segesterone Acetate; Ethinyl Estradiol
- Silodosin
- Simeprevir
- Sirolimus
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sorafenib
- St. John’s Wort, Hypericum perforatum
- Sunitinib
- Talazoparib
- Telithromycin
- Tenofovir Alafenamide
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Tezacaftor; Ivacaftor
- Ticagrelor
- Tipranavir
- Tolvaptan
- Topotecan
- Trandolapril
- Trandolapril; Verapamil
- Tuberculin Purified Protein Derivative, PPD
- Tucatinib
- Ubrogepant
- Umeclidinium
- Umeclidinium; Vilanterol
- Vemurafenib
- Venetoclax
- Verapamil
- Vinblastine
- Vincristine
- Vincristine Liposomal
- Voriconazole
- Zonisamide
