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Care During Chemotherapy and Beyond

Elotuzumab

(el-oh-TOOZ-ue-mab)

Trade Name: Empliciti®

Elotuzumab is the generic name for the trade name, Empliciti. In some cases, health care professionals may use the trade name, Empliciti, when referring to the generic drug name, elotuzumab.

Dryg Type: Elotuzumab is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as a "monoclonal antibody (anti SLAMF7)". (For more detail see "How Elotuzumab Works" below.)

What Elotuzumab Is Used For:

  • Elotuzumab is used in combination with lenalidomide and dexamethasone for patients with multiple myeloma who have received 1 to 3 prior therapies.

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 Elotuzumab Is Given:

  • Elotuzumab is given as a slow IV infusion. You will receive multiple pre-medications prior to the start of the elotuzumab infusion Elotuzumab is usually given as 8 weekly infusions, followed by an infusion every 2 weeks. You would also be taking oral medications, lenalidomide and dexamethasone as prescribed.

The amount of elotuzuman 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 your exact dosage and schedule.

Side Effects:

Important things to remember about the side effects of elotuzumab:

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

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

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

Delayed Effects of Elotuzumab:

There is a slight risk of developing a solid tumor or skin cancer years after taking elotuzumab. Talk to your doctor about this risk.

Not all side effects are listed above. Side effects that are rare -- occurringin 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 100.4º F (38º 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)
  • Mouth sores (painful redness, swelling or ulcers)
  • Constipation unrelieved by laxative use.
  • Yellowing of the skin or eyes.
  • Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.
  • 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 elotuzumab teatment, 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.
  • Do not take Echinacea
  • Your physician will evaluate if other monoclonal antibodies are safe during your treatment with elotuzumab (for example, denosumab (Xgeva) may be discontinued while you are on elotuzumab.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking elotuzumab.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category X (Elotuzumab is given in combintation with lenalidomide which may cause fetal harm when given to a pregnant woman. This drug must not be given to a pregnant woman or a woman who intends to become pregnant. If a woman becomes pregnant while taking elotuzumab, the medication must be stopped immediately and the woman given appropriate counseling).
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking elotuzumab. Barrier methods of contraception, such as condoms, are recommended for up to 3 months after last dose of elotuzumab.
  • Do not breast feed while taking elotuzumab.

Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • You may be at risk of infection so try to avoid crowds or people with colds or those not feeling well, 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).
  • Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be cause by this medicine.
  • Avoid sun exposure. Wear SPF 30 (or higher) sunblok 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:

You will be checked regularly by your doctor while you are taking elotuzumab, to monitor side effects and check your response to therapy. Periodic blood work will be obtained 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.

Elotuzumab may interfere with the usual blood tests used to monitor your multiple myeloma.

How Elotuzumab 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 part of the cells. Other targeted therapies target receptors that are on the outside of the cell. Therapies that target receptors are also know as monoclonal antibodies. Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Researchers agree that targeted therapies are not a replacement for traditional therapies. They may be best used in combination with traditional therapies. More research is needed to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer.

Elotuzumab is a humanized IgG1 immunostimulatory monoclonal antibody which is directed against signaling lymphocytic activation molecule family member 7 (SLAMF7). SLAMF7 is expressed on most myeloma and natural killer cells but not on normal tissues. Elotuzumab directly activates natural killer cells and targets SLAMF7 on myeloma cells. Elotuzuma mediates antibody-dependent cellular cytotoxicity (ADCC) through the CD16 pathway. This activity stimulates your immune system with increased activation of natural killer cells and increases the anti-tumor activity.

Note: We strongly encourage you to tal 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.

Reference:

Elotuzumab. Lexicomp Online® Lexi-Drugs®. Hudson, Ohio: Lexi-Comp, Inc.; January 22, 2016.

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