(ax-i-CAB-tay-jeen-sye-LO-loo-sel)
Trade Name(s): Yescarta®
Axicabtagene Ciloleucel is the generic name for the trade name drug Yescarta®. In some cases, health care professionals may use the trade name Yescarta® when referring to the generic drug name Axicabtagene Ciloleucel.
Drug Type: Axicabtagene Ciloleucel is an anti-cancer immunotherapy drug. This medication is classified as a "Chimeric Antigen Receptor T-Cell (CAR T-Cell) immunotherapy agent." (For more detail, see "How Axicabtagene Ciloleucel Works" below)
What Axicabtagene Ciloleucel Is Used For
- Lymphoma if the cancer has relapsed or progressed after standard treatments
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 Axicabtagene Ciloleucel Is Given
- Axicabtagene Ciloleucel is made from your own white blood cells. Your white blood cells are collected using an apheresis machine, which will separate the necessary cells from your blood and return the rest of your cells to you through a needle in your vein. Your cells will then be sent to a manufacturing center to make your dose of axicabtagene ciloleucel which can take several weeks.
- Axicabtagene Ciloleucel is given once by IV infusion over 30 minutes. You will receive chemotherapy with fludarabine and cyclophosphamide for three days beginning five days before the treatment with axicabtagene ciloleucel to prepare your body for the infusion.
- You will be given acetaminophen and an antihistamine approximately one hour before the infusion to reduce the risk of infusion related reactions.
- Because of side effects, axicabtagene ciloleucel must be administered to you while you are hospitalized (as an inpatient) and only certain healthcare facilities can administer axicabtagene ciloleucel.
- After the axicabtagene ciloleucel infusion, you will be monitored daily for at least seven days and possibly longer. You will need to stay close to where you received the axicabtagene ciloleucel for at least four weeks after the infusion for close monitoring.
Side Effects
Important things to remember about the side effects of Axicabtagene Ciloleucel:
- Axicabtagene Ciloleucel side effects are often predictable in terms of their onset, duration, and severity.
The following side effects are common (occurring in greater than 30%) for patients taking Axicabtagene Ciloleucel:
A commonly reported side effect with axicabtagene ciloleucel is cytokine release syndrome. This occurs when your immune system is activated by the axicabtagene ciloleucel treatment and releases proteins called "cytokines" in your body. As a result of this, you may start to experience chills, fevers, low blood pressure, difficulty breathing, or confusion. Sometimes, these symptoms can become severe enough that you may need intensive supportive care in an intensive care unit and receive medications that will stop the cytokine release syndrome.
Neurological symptoms, including confusion, headaches, dizziness, hallucinations, seizures and anxiety have been reported within 8 weeks of receiving axicabtagene ciloleucel. You will be closely monitored for these symptoms after receiving axicabtagene ciloleucel by your healthcare team. Sometimes, these symptoms can become severe enough to require supportive care management with medications. Contact your health care provider immediately if you start to experience any of these symptoms or note any changes in behavior.
These are less common side effects (occurring in 10-29%) for patients receiving Axicabtagene Ciloleucel:
Note 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 100.4º F (38º C) or higher, chills (possible signs of infection)
- Difficulty breathing
- Confusion
- Dizziness or lightheadedness
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)
Always inform your health care provider if you experience any unusual symptoms.
Precautions
- Before starting axicabtagene ciloleucel 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 or 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 axicabtagene ciloleucel.
- 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.
- You may experience drowsiness, sleepiness, confusion or dizziness; avoid driving or engaging in tasks that require alertness for 8 weeks after you receive axicabtagene ciloleucel.
- Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. There have been no animal or human studies with axicabtagene ciloleucel in pregnant women and it is unknown if axicabtagene ciloleucel is transferred to the fetus. If axicabtagene ciloleucel is transferred to the fetus, this may cause fetal toxicity and a decrease in the fetus' white blood cells so it is recommended to avoid axicabtagene ciloleucel if you are pregnant or planning to become pregnant.
- Do not breast feed while taking axicabtagene ciloleucel.
Self-Care Tips
- Alert any new health care professional or emergency room worker that you have received axicabtagene ciloleucel in the past. You will be provided with YESCARTA® wallet sized card from the manufacturing company informing them of the most common symptoms to monitor for.
- Wash your hands often.
- You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your health care provider.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- This medication causes some nausea. But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
- 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).
- 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 Axicabtagene Ciloleucel
You will be checked regularly by your doctor while you are taking Axicabtagene Ciloleucel to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC), immunoglobulin levels as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How Axicabtagene Ciloleucel Works
Immunotherapy is a relatively new type of cancer therapy that uses the body's own immune system to identify and fight the cancer.
CAR T-Cell therapy is a newly developed immunotherapy treatment that genetically engineers your T-cells to produce special receptors called chimeric antigen receptors (CARs). These CARs let your T-cells recognize cancer cells. After these CAR T-cells are infused into the patient, they start attacking the cancer cells.
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.