Zevalin®

Class: Biologic therapy

Generic Name: Ibritumomab tiuxetan

Trade Name: Zevalin®

How is this drug used? Zevalin is FDA approved for patients with relapsed or refractory low-grade or follicular B-cell non-Hodgkin’s lymphoma (NHL), as well as for patients with previously untreated follicular NHL who have a partial or complete response to initial chemotherapy.

Zevalin is given as part of the Zevalin therapeutic regimen, which also includes treatment with Rituxan® (rituximab).

What is the mechanism of action? Zevalin is a type of agent called a radioimmunotherapeutic. It is comprised of two different portions: a monoclonal antibody and a radioactive isotope. The monoclonal antibody portion has been developed through laboratory processes to bind to a particular part of B-cells, which comprise the majority of cancerous cells in non-Hodgkin’s lymphoma. It is thought that this binding action stimulates the immune system to attack the cancer cells. In addition, the radioisotope that is attached to the monoclonal antibody spontaneously emits radiation, killing cancer cells in a second manner.

How is Zevalin given (administered)? Zevalin is administered intravenously (into a vein).

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with Zevalin. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver.  Patients may also undergo physical examinations, scans or other measures to assess tolerance and response to therapy.

What are the most common side effects of treatment with Zevalin?

• Low blood cell counts
• Fatigue
• Abdominal pain
• Nausea
• Nasopharyngitis
• Weakness
• Diarrhea
• Cough
• Fever

What are serious side effects that can occur with Zevalin?

• Low blood cell counts that are prolonged and severe. These may lead to complications such as bleeding or severe infection.
• Severe skin reactions, which can be fatal.
• Myelodysplastic syndrome ( a group of diseases marked by abnormal production of blood cells by the bone marrow) and/or acute myelogenous leukemia (AML)

Rarely, patients experience severe reactions during the Rituxan infusion that is part of this treatment regimen. Although patients will be closely monitored for this reaction, they should tell their healthcare provider immediately if they experience the following symptoms: shortness of breath, difficulty breathing, chest pain, noticeable changes in heart rate or rhythm, fever, chills, hives, flushing, lightheadedness or dizziness. Patients may also experience low blood pressure and fluid accumulation as part of this reaction.

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, avoid large crowds or people who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Eat small meals frequently to help alleviate nausea.Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. I
• It is important that patients inform their physician of all other medical conditions, including current or recent infections.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment, especially medications that affect blood clotting (blood thinners).
• Patients should inform their physician about any recent or planned vaccinations. Immunization with live viral vaccines is not recommended for 12 months after the Zevalin treatment regimen.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.

When should patients notify their physician?

Tell your doctor if you experience any side effects that bother you or don’t go away. Also tell your doctor if you experience any of the following:

• Signs of a reaction to Rituxan (see Rituxan information) or Zevalin – difficulty breathing, shortness of breath, chest pain, noticeable changes in heart rate or rhythm, lightheadedness, dizziness, low blood pressure, fever, chills, flushing
• Flu or cold-like symptoms – fever, chills, sore throat, cough
• Signs of infection – fever, redness, swelling, pus, tenderness, painful urination
• Unexplained or excessive bleeding (nosebleeds, bruising, black tarry stools, blood in the urine, etc.)
• Severe or persistent fatigue
• Pallor
• Rash or other changes in the skin or lining of the mouth

What is a package insert?

A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Copyright © 2011 CancerConnect Last updated 05/11.

Important Limitations of Use

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