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Care During Chemotherapy and Beyond

Moxetumomab Pasudotox-tdfk

(mox e TOOM oh mab)

Trade Name: Lumoxiti®

Moxteumomab is the generic name for the trade name drug Lumoxiti. In some cases, health care professionals may use the trade name Lumoxiti when referring to the generic drug name moxetumomab.

Drug Type: Moxetumomab is classified as a monoclonal antibody (For more detail, see "How Moxetumomab Works" below).

What Moxetumomab Is Used For

  • Hairy cell leukemia

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 Moxetumomab Is Given

  • This drug is given by infusion into a vein by intravenous (IV) route.
  • Pre-medications may be given before the infusion to reduce the chance of infusion-related symptoms.
  • The amount of moxetumumab that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine you exact dosage and schedule.

Side Effects

Important things to remember about the side effects of moxetumomab:

  • Most people will not experience all of the side effects listed.
  • Moxetumomab's side effects are often predictable in terms of their onset, duration, and severity.
  • Most side effects will improve after therapy is complete.
  • Many of the side effects may be quite manageable. There are many options to minimize or prevent the side effects of moxetumomab.

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

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

These are rare but serious complications of moxetumomab:

  • Infusion-related reactions (symptoms that may occur within the first 30-60 minutes after the infusion in started):
    • Fever, chills, nausea and vomiting, itching, skin rash, fatigue, headache, diarrhea, shortness or breath, and/or low blood pressure
    • Medications are given before the infusion to reduce the chance or severity of infusion-related reactions, and the infusion is started at a low dose and is gradually increased as tolerated. You will be monitored during the infusion for these symptoms.
  • Capillary leak syndrome:
    • A rare, but potentially serious disease in which fluids within the vascular system (veins and capillaries) leaks into the tissue outside the bloodstream. This results in low blood pressure and poor blood flow to the internal organs. Capillary leak syndrome is characterized by the presence of 2 or more of the following 3 symptoms: low blood pressure, swelling, and low levels of protein in the blood. Your doctor will monitor these things carefully while you are taking moxetumomab. You should notify your doctor immediately if you notice dizziness (especially when changing position), sudden swelling or rapid weight gain, little or no urine output (for 8-12 hours), shortness of breath, difficulty breathing, irregular heartbeats, or chest pain.
  • Hemolytic uremic syndrome:
    • A rare, but serious blood problem that may cause tiredness or weakness, bleeding or bruising, pale skin, seizures, shortness of breath, stomach pain, or vomiting. Your doctor will monitor you carefully for these things while you are taking moxetumomab. Notify your doctor right away if you experience any of these symptoms.

Not all of the sire effects are listed above. 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:

  • Rash, hives, itching, wheezing, tightness of chest or throat, trouble breathing, swelling of the mouth, lips, tongue, or throat (possible allergic reaction).
  • If you are unable to pass urine, there is a change in how much urine is passed, or there is blood in your urine (possible signs of kidney problems).
  • Mood changes, confusion, muscle pain or weakness, an abnormal heartbeat, seizures (possible signs of electrolyte problems).
  • Headache or dizziness, passing out, or changes in eyesight (possible signs of high blood pressure).
  • Fever of 100.4┬║ F (38┬║ C) or higher, chills (possible signs of 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)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)

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

Precautions

  • Before starting moxetumomab treatment, make sure you tell you doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking moxetumomab.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. There are no available data on use in pregnant women to inform a drug-associated risk of major birth defects and miscarriage.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking moxetumomab. Barrier methods of contraception, such as condoms, are recommended.
  • Do not breast feed while taking moxetumomab.

Self-Care Tips

  • Drink at least two to three quarts of fluid every 24 hours, especially for Days 1 through 8 of each 28-day treatment cycle, unless you are instructed otherwise.
  • 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 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 30 (or higher) sunblock 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.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • 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 While Taking Moxetumomab

You will be checked regularly by your doctor while you are taking moxetumomab to monitor the side effects and check your response to therapy. Periodic blood work will be obtined to monitor your complete blood counts (CBC) as well as the function of other organs (such as your kidneys and liver) by your doctor. Your doctor will also regularly check your weight and blood pressure while you are taking moxetumomab.

How Moxetumomab Works

Moxetumomab is classified as a monoclonal antibody. Monoclonal antibodies are a relatively new type of cancer therapy.

Antibodies are an integral part of the body's immune system. Normally the body creates antibodies in response to an antigen (such as a protein or a germ) that has entered the body. The antibodies attach to the antigen in order to mark it for destruction by the immune system. To make anti-cancer antibodies in the laboratory, scientists analyze specific antigens on the surface of cancer cells (the targets). Then, using animal and human proteins, they create a specific antibody that will attach to the target antigen on the cancer cells. When given to a patient, these antibodies will attach to matching antigens like a key fits a lock. Since antibodies target only specific cells, they may cause less toxicity to healthy cells. Monoclonal antibody therapy is usually only given for cancer in which antigens and the respective antibodies have been identified already.

Moxetumomab works by targeting the CD22 antigen on cancerous B-cells. However, it is more than a monoclonal antibody alone. In the laboratory, a bacterial protein toxin is linked to the antibody. When the antibody attaches to the CD22 antigens, the toxin is release directly into the cancer cells, killing the cancer cells as well as the cells in the immediate area. Stem cells (young cells in the bone marrow that will develop into the various types of cells) do not have the CD22 antigen. This allows helathy B-cells to regenerate after treatment. The CD22 antigens are also not present on the normal cells, making this drug a targeted therapy specific to your cancer. This type of therapy is also known as immunotoxin therapy.

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.

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