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Care During Chemotherapy and Beyond

Jevtana

Generic Name(s): cabazitaxel

Cabazitaxel is the generic name for the trade name drug Jevtana®. In some cases, health care professionals may use the trade name Jevtana® when referring to the generic drug name cabazitaxel.

Drug Type:

Jevtana is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as a "taxane derivitive" and an "anti-microtubule agent." (For more detail, see "How Jevtana Works" below)

What Jevtana Is Used For:

  • Jevtana is approved for treatment [in combination with prednisone] for treatment of patients with castrate resistant metastatic prostate cancer previously treated with a docetaxel-containing treatment regimen. 

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 Jevtana Is Given:

  • Jevtana is given through a vein (intravenously, IV)
  • There is no pill form of Jevtana.
  • You will take a corticosteroid pill, prednisone, twice a day, every day while being treated with Jevtana.
  • You will be given pre-medications about 30 minutes prior to each Jevtana infusion.  This is to decrease the risk of having a reaction to the Jevtana.

The amount of Jevtana 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 Jevtana:

  • Most people will not experience all of the Jevtana side effects listed.
  • Jevtana side effects are often predictable in terms of their onset, duration, and severity.
  • Jevtana side effects are often reversible and are likely to improve after therapy is complete.
  • Jevtana side effects may be quite manageable. There are many options to minimize or prevent the side effects of cabazitaxel.
  • There is no relationship between the presence or severity of side effects and the efficacy of the medication

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

  • Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.

    • Nadir: this is the 'low point'. It is the point at which your blood counts are the lowest they will be during this treatment.
      Nadir: 8-12 day
  • Diarrhea 
  • Fatigue 
  • Nausea

The following side effects are less common (occurring in 10-29%) side effects for patients receiving Jevtana:

Infusion-related side effects (symptoms which may occur while the drug is going into the vein) include:

  • Allergic reactions (rash, flushing, fever, lowered blood pressure). This happens rarely, usually occurs the first or second infusion.  Premedication as described above reduces the frequency of this reaction.  You will be closely monitored during the infusion for any signs of allergic reaction.
  • Infusion site reactions: consist of darkening of the vein, redness of the skin, swelling of the vein, or pain

Not all side 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:

  • 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
  • Extreme fatigue (unable to carry on self-care activities)
  • Yellowing of the skin or eyes
  • Shortness of breath
  • Significant changes in urination (decreased amounts of urine output) 

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

Precautions:

  • Before starting Jevtana 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.
  • Do not receive any kind of immunization or vaccination without your doctor’s approval while taking Jevtana.
  • You should refrain from taking St. John's Wort.
  • Avoid drinking grapefruit juice or eating grapefruit. 
  • Currently, Jevtana is approved for the treatment of castrate resistant metastatic prostate cancer only (male population). However, there are no well-controlled studies regarding Jevtana use in pregnant women. Jevtana may cause fetal harm if administered during pregnancy.  Pregnant women should avoid exposure to Jevtana.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking Jevtana. Barrier methods of contraception, such as condoms, are recommended.

Self-Care Tips:

  • 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.
  • 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.
  • It is very important to take your prednisone pills as prescribed. 
  • 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) 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.
  • Elderly patients may be at risk for more frequent of severe side effects. 
  • Get plenty of rest.
  • Maintain good nutrition. (see eating well during chemotherapy)
  • 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 Jevtana, 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.

How Jevtana Works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.  "Normal" cells stop dividing when they come into contact with similar cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normal checks and balances in place that control and limit cell division.

The ability of chemotherapy to kill cancer cells depends on its ability to stop cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink.

Chemotherapy is most effective at killing cells that area rapidly dividing.  Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells.  The "normal" cells most commonly affected by chemotherapy are the rapidly dividing cells in the body such as; the blood cells, the cells in the mouth, stomach, bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.  Different drugs may affect different parts of the body.

Jevtana is a microtubule inhibitor.  Microtubules are essential to cell division, and taxanes, such as Jevtana, stabilize a particular type of protein in the microtubule, thereby inhibiting the process of cell division.  This prevention of cell/division/growth ultimately results in cell death.

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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