What is Yervoy?
Yervoy (ipilimumab) is a monoclonal antibody used to treat specific cancers including melanoma, non-small cell lung cancer (NSCLC), pleural mesothelioma, esophageal cancer, kidney cancer (RCC), liver cancer, or colorectal cancer. Yervoy can be used alone or combined with another cancer medicine such as Opdivo (nivolumab).
Yervoy is an immunotherapy that blocks a protein (antigen) that can stop your immune system from working properly and attacking cancer cells. When Yervoy has blocked the protein (CTLA-4) the immune system is able to find and kill the cancer cells.
Yervoy is from the class of medicines called immune checkpoint inhibitors, and because it blocks the T-lymphocyte antigen 4 (CTLA-4), it is called a CTLA-4 inhibitor.
Yervoy became an FDA-approved medicine on August 18, 2010, for treating advanced melanoma, and since then, the FDA approval has been extended to include a range of cancers.
How does Yervoy work?
T-cells are white blood cells that are part of the immune system involved in finding and killing cancer cells. There is a protein called cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) on the surface of the T-cells that suppresses immune activity. Yervoy blocks the CTLA-4 antigen, activating the immune response to find and attack the cancer cells.
What is Yervoy used for?
Yervoy is FDA-approved to treat a range of specific cancers, including
- skin cancer (melanoma)
- non-small cell lung cancer (NSCLC) expressing PD-L1 (≥1%) with no EGFR or ALK genomic tumor aberrations
- Malignant pleural mesothelioma that is unresectable
- squamous cell cancer of the esophagus
- kidney cancer (renal cell carcinoma (RCC))
- liver cancer (hepatocellular carcinoma)
- colorectal cancer that is microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer
- esophageal cancer that is unresectable advanced or metastatic esophageal squamous cell carcinoma.
To be treated with Yervoy you must have a specific form of the cancer and meet the specific conditions. For more information see Prescribing Information.
Yervoy is often given when the cancer has spread to other parts of the body, cannot be surgically removed, or has come back after prior treatment.
Yervoy side effects
Common Yervoy side effects
The most common side effects include:
- fever, cough, shortness of breath;
- nausea, vomiting, stomach pain, loss of appetite;
- diarrhea, constipation;
- weight loss;
- hormonal problems;
- rash or itching;
- headache, dizziness, tiredness;
- sleep problems (insomnia); or
- pain in your muscles, joints, or bones.
Serious Yervoy side effects
Get emergency medical help if you have signs of an allergic reaction to this medicine (hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Some side effects may occur during the injection. Tell your caregiver if you feel dizzy, light-headed, short of breath, itchy, tingly, chilled, or feverish.
Serious and sometimes fatal reactions may occur during treatment with this medicine or months after your last dose. Call your doctor right away if you have symptoms such as:
- severe or ongoing diarrhea, severe stomach pain, bloody or tarry stools;
- fever, swollen glands, body aches;
- new or worsening skin rash, itching, or blistering;
- painful sores in mouth or nose, throat, or genital area;
- chest pain, irregular heartbeats;
- severe muscle weakness, ongoing pain in your muscles or joints;
- numbness or tingling in your hands or feet;
- vision problems, eye pain or redness;
- lung problems - new or worsening cough, chest pain, feeling short of breath;
- kidney problems - little or no urination, swelling in your feet or ankles, blood in your urine;
- liver problems - right-sided upper stomach pain, tiredness, bruising or bleeding, dark urine, yellowing of your skin or eyes;
- signs of a hormonal disorder - frequent or unusual headaches, lack of energy, dizziness, fainting, mood or behavior changes, increased thirst or urination, feeling cold, weight gain, or weight loss; or
- symptoms of brain swelling - confusion, headache, memory problems, hallucinations, neck stiffness, drowsiness, seizure (convulsions).
Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.
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.
Serious and sometimes fatal reactions may occur during treatment with this medicine or months after your last dose. Call your doctor at once if you have: chest pain, cough, shortness of breath, vision changes, severe muscle pain or weakness, diarrhea and severe stomach pain, blood in your stools, little or no urinating, swelling, bruising or bleeding, dark urine, yellowing of the skin or eyes, confusion, hallucinations, a seizure, skin blistering, or a hormonal disorder (frequent headaches, feeling light-headed, increased thirst or urination, feeling cold, weight gain or loss).
Before you receive Yervoy, tell your doctor if you have liver damage, an autoimmune disorder such as lupus or sarcoidosis, Crohn's disease, ulcerative colitis, or if you have received an organ transplant.
Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.
Before taking this medicine
You should not receive this medicine if you are allergic to the active ingredient ipilimumab or any of the inactive ingredients.
To make sure Yervoy is safe for you, tell your doctor if you have ever had:
- liver problems;
- an autoimmune disorder (lupus, sarcoidosis, Crohn's disease, ulcerative colitis);
- an organ transplant or stem cell transplant; or
- a nerve-muscle disorder, such as myasthenia gravis, or Guillain-Barre syndrome.
This medicine is not approved for use by anyone younger than 12 years old and for some types of cancer, it is used only in adults.
Yervoy may harm an unborn baby.
You may need to have a negative pregnancy test before starting this treatment. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 3 months after your last dose. Tell your doctor if you become pregnant.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of ipilimumab on the baby.
Do not breastfeed while using this medicine, and for at least 3 months after your last dose.
How is Yervoy given?
Yervoy is given as an infusion into a vein (IV infusion). A healthcare provider will give you this injection.
This medicine must be given slowly, and the infusion can take 30-90 minutes to complete.
Yervoy is usually given once every 3 to 6 weeks, depending on which type of cancer is being treated. Your other cancer medications may be given more often. Your doctor will determine how long to treat you with all medicines.
Yervoy can be used alone or combined with other cancer medicines such as Opdivo (Nivolumab).
You may be given other medications to treat or prevent certain side effects.
You may need frequent medical tests and your cancer treatments may be delayed based on the results.
Yervoy is available as an Injection: 50 mg/10 mL (5 mg/mL) or 200 mg/40 mL (5 mg/mL) in a single-dose vial.
What happens if I miss a dose?
Call your doctor for instructions if you miss a chemotherapy appointment.
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 receiving Yervoy?
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Active ingredients: ipilimumab
Inactive ingredients: diethylene triamine pentaacetic acid (DTPA), mannitol, polysorbate 80 (vegetable origin), sodium chloride, tris hydrochloride, and Water for Injection, USP at a pH of 7.
- Store refrigerated at 2°C to 8°C (36°F to 46°F).
- Protect from light by storing it in the original carton until the time of use.
- Do not freeze or shake.
Manufactured by: Bristol-Myers Squibb Company, Princeton, NJ 08543 USA.
Opdivo and Yervoy are administered by slow intravenous infusion over at least 30 minutes – this is when a bag containing the medicine is hung from a stand, and the medicine runs through a piece of tubing called an intravenous line into your vein. This needs to be done in your doctor’s office, an infusion center, or a hospital. Continue reading
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