Generic Name: axicabtagene ciloleucel (AKS ee KAB ta jeen SYE loe LOO sel)
Brand Name: Yescarta
What is axicabtagene ciloleucel?
Axicabtagene ciloleucel is an immunotherapy medicine used to treat large B-cell lymphoma in adults. This medicine is given after at least two other treatments have failed.
Axicabtagene ciloleucel is made from your own white blood cells, removed from a small amount of blood drawn from your body.
Axicabtagene ciloleucel is available under a special program. You must be registered in the program and understand the risks and benefits of this medicine.
Axicabtagene ciloleucel may also be used for purposes not listed in this medication guide.
What is the most important information I should know about axicabtagene ciloleucel?
A serious side effect of this medicine is called cytokine release syndrome, which causes fever, chills, trouble breathing, vomiting, and other symptoms. Your caregivers will have medication available to quickly treat this condition if it occurs.
Axicabtagene ciloleucel can also cause life-threatening nerve problems. Tell your caregivers or seek emergency medical attention if you have problems with speech, problems with thinking or memory, confusion, or a seizure.
What should I discuss with my healthcare provider before taking axicabtagene ciloleucel?
To make sure axicabtagene ciloleucel is safe for you, tell your doctor if you have ever had:
an active or chronic infection;
liver or kidney disease;
a stroke; or
if you have received a vaccine in the past 2 weeks.
Women may need pregnancy testing before receiving this medicine. You may also need to use birth control to prevent pregnancy during and shortly after treatment with axicabtagene ciloleucel and chemotherapy.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
If you receive axicabtagene ciloleucel during pregnancy, your baby's blood may need to be tested after it is born. This is to evaluate any effects the medicine may have had on the baby.
It is not known whether axicabtagene ciloleucel passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.
How should I take axicabtagene ciloleucel?
Your care providers will use an intravenous (IV) needle to draw your blood for collecting the white blood cells. The cells are then frozen and sent to a laboratory where they are made into axicabtagene ciloleucel.
About 3 to 5 days before axicabtagene ciloleucel is given, you will be pre-treated with chemotherapy to help prepare your body for axicabtagene ciloleucel.
Just before you receive axicabtagene ciloleucel, you will be given other medications to help prevent serious side effects or allergic reaction.
Once your body is ready to receive axicabtagene ciloleucel, your care providers will inject the medicine into a vein through an IV.
You will be watched closely for at least 7 days after you receive axicabtagene ciloleucel, to make sure you do not have an allergic reaction or serious side effects.
You will need frequent blood tests to be sure this medicine has not caused harmful effects.
For at least 4 weeks, plan to stay near the hospital or clinic where you received axicabtagene ciloleucel. Avoid being so far away that it takes you longer than 2 hours to travel back to the hospital.
What happens if I miss a dose?
Call your doctor for instructions if you miss any of your chemotherapy treatment, or if you miss a dose of your medications to prevent side effects of axicabtagene ciloleucel.
What happens if I overdose?
Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid while taking axicabtagene ciloleucel?
This medicine can cause weakness, drowsiness, confusion, problems with memory or coordination, and seizures. Avoid driving or operating machinery for at least 8 weeks after you are treated with axicabtagene ciloleucel.
Do not donate blood, an organ, or any tissues or cells from your own body.
Do not receive a "live" vaccine while using axicabtagene ciloleucel, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
Axicabtagene ciloleucel side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
A serious side effect of axicabtagene ciloleucel is called cytokine release syndrome (CRS). Tell your caregivers right away if you have signs of this condition: fever, chills, trouble breathing, confusion, severe vomiting or diarrhea, fast or irregular heartbeats, feeling light-headed, or feeling very weak or tired. Your caregivers will have medication available to quickly treat CRS if it occurs.
Also tell your caregivers or seek emergency medical attention if you have signs of life-threatening nerve problems: problems with speech, problems with thinking or memory, confusion, or a seizure.
Also call your doctor at once if you have:
tremors, anxiety, trouble sleeping;
unusual thoughts or behavior;
trouble speaking or understanding what is said to you; or
low blood cell counts--fever, chills, tiredness, flu-like symptoms, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath.
Common side effects may include:
low blood cells;
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Axicabtagene ciloleucel dosing information
Usual Adult Dose for Lymphoma:
2 x 10(6) chimeric antigen receptor (CAR)-positive viable T cells per kg body weight via IV infusion; infuse within 30 minutes
-Maximum Dose: 2 x 10(8) CAR-positive viable T cells
-Pre-treatment: Administer a lymphodepleting chemotherapy regimen of cyclophosphamide 500 mg/m2 IV and fludarabine 30 mg/m2 IV on the fifth, fourth, and third day before infusion of this drug.
-Premedication: Administer acetaminophen 650 mg orally and diphenhydramine 12.5 mg IV or orally approximately 1 hour before infusion of this drug.
-Avoid prophylactic use of systemic corticosteroids as it may interfere with the activity of this drug.
-This drug is not indicated for the treatment of primary central nervous system lymphoma.
Use: Treatment of relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, primary mediastinal large B-cell lymphoma, high grade B-cell lymphoma, and DLBCL arising from follicular lymphoma.
What other drugs will affect axicabtagene ciloleucel?
Other drugs may interact with axicabtagene ciloleucel, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
Where can I get more information?
- Your pharmacist can provide more information about axicabtagene ciloleucel.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 1.01.
Last reviewed: November 06, 2017
Date modified: December 03, 2017