(tem sir OH li mus)

Trade Name: Torisel ®
Other Name:  CCI-779

Temsirolimus is the generic name for the trade name chemotherapy drug Torisel. In some cases, health care professionals may use the trade name Torisel when referring to the generic drug name Temsirolimus.

Drug Type:

Temsirolimus is a targeted therapy and is classified as a mTOR inhibitor.

What Temsirolimus Is Used For:

Temsirolimus is used in the treatment of advanced renal cell cancer

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Temsirolimus Is Given:

• Temsirolimus is given as an injection into the vein (intravenous, IV).
• The amount of Temsirolimus that you will receive will be prescribed by your doctor based on established dosing guidelines.

Side Effects:

Important things to remember about the side effects of Temsirolimus:

• Most people do not experience all of the Temsirolimus side effects listed.
• Temsirolimus side effects are often predictable in terms of their onset and duration.
• Temsirolimus side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent Temsirolimus side effects.

The following Temsirolimus side effects are common (occurring in greater than 30%) for patients taking Temsirolimus:

• Weakness
• Low blood counts Your red blood cells and platelets may temporarily decrease. This can put you at increased risk for anemia and/or bleeding.
• Rash
• Mouth sores
• Nausea
• Swelling
• Poor appetite
• Increased blood glucose levels (hyperglycemia)
• Increase in blood cholesterol levels
• Decrease in blood phosphate levels (hypophosphatemia)
• Increased liver enzymes
• Increased blood creatine levels

These are less common (occurring in about 10-29%) side effects for patients receiving Temsirolimus:

• Shortness of breath
• Pain
• Swelling in legs and feet
• Diarrhea
• Cough
• Fever
• Low potassium
• Abdominal pain
• Infection
• Constipation
• Taste disturbance
• Back pain
• Itching
• Vomiting
• Weight loss
• Low white blood cell count
• Generalized aches and pains
• Chest pain
• Headache
• nail disorder/thinning
• Insomnia
• Nose bleed
• Sore throat
• Dry skin

This list includes common and less common side effects for those taking Temsirolimus. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

• Fever of 100.4° F (38° C) or higher, chills (signs of possible infection).

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

• Nausea (interferes with ability to eat and unrelieved with prescribed medication).
• Vomiting (vomiting more than 4-5 times in a 24 hour period).
• Diarrhea (4-6 episodes in a 24-hour period).
• Constipation unrelieved by laxative use.
• New or worsening abdominal pain.
• Unusual bleeding or bruising
• Black or tarry stools, or blood in your stools.
• Blood in the urine.
• Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.
• Extreme fatigue (unable to carry on self-care activities).
• Mouth sores (painful redness, swelling or ulcers).
• Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

• Before starting Temsirolimus treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
• Avoid grapefruit and grapefruit juice (may increase the levels/adverse effects of temsirolimus).
• Do not receive any kind of immunization or vaccination without your doctor’s approval while taking Temsirolimus. Avoid close contact with recently vacinnated (live vaccine) individuals.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (temsirolimus may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
• For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking Temsirolimus. Barrier methods of contraception, such as condoms, are recommended.
• Do not breast feed while taking Temsirolimus.

Self-Care Tips:

• Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. This will decrease your chances of being constipated, and prevent dehydration.
• You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
• Wash your hands often.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
• Use an electric razor and a soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• Follow regimen of anti-diarrhea medication as prescribed by your health care professional.
• Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
• Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
• Get plenty of rest.
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking Temsirolimus, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How Temsirolimus Works:

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly. Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects.

Targeted therapy is about identifying other features of cancer cells. Scientists look for specific differences in the cancer cells and the normal cells. This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects. Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells.

There are different types of targeted therapies, defined in three broad categories. Some targeted therapies focus on the internal components and function of the cancer cell. The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die. There are several types of targeted therapy that focus on the inner parts of the cells. Other targeted therapies target receptors that are on the outside of the cell. Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Research continues to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer.

Temsirolimus is an inhibitor of mTOR. mTOR inhibition blocks the translation of genes that regulate cancer cell proliferation. It also results in reduced levels of certain cell growth factors involved in the development of new blood vessels, such as vascular endothelial growth factor (VEGF).

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org