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Care During Chemotherapy and Beyond

Axitinib

(Ax I ti nib)

Trade Name: Inlyta®

Axitinib is the generic name for the trade name drug Inlyta®. In some cases, health care professionals may use the trade name Inlyta® when referring to the generic drug name axitinib.

Drug Type:  Axitinib is a targeted therapy and is a receptor protein-kinase inhibitor. It inhibits the actions of vascular growth factor (VEGF) and is an angiogenesis inhibitor.    (For more detail, see “How Axitinib Works” below)

What Axitinib Is Used For:

  • Treatment of advanced renal cell carcinoma after the failure of one prior systemic therapy.

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 Axitinib Is Given:

  • Axitinib is given as a pill by mouth.
  • Swallow whole with a full glass of water.
  • Can be taken with or without food. 
  • The amount of axitinib that you will receive depends on many factors, including 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.

Axitinib Side Effects:

Important things to remember about the side effects of axitinib:

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

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

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

Rare (2-3%) but serious side effects include:

  • bleeding events
  • a tear in your stomach or intestinal wall (referred to as a perforation).
  • blood clots, including deep vein thrombosis (DVT) and pulmonary embolus.  You should seek emergency help and notify your health care provider immediately if you develop sudden chest pain and shortness of breath.  Notify your health care provider within 24 hours if you notice that one leg is swollen, red, painful and/or warm to touch and the other is not.

  • Reversible Posterior Leukoencephalopathy Syndrome (RPLS). This is a very rare condition that can happen while taking Inlyta. Symptoms include headache, seizure, confusion, blindness or change in vision, or problems thinking.

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:

  • Blood pressure readings that is very high, including the systolic BP (top number) higher than 160 or the diastolic number (bottom number) higher than 100.
  • 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:

  • Blood pressure readings that is high, including the systolic BP (top number) higher than 150 or the diastolic number (bottom number) higher than 90. Your physician may give you different guidelines regarding when to call about blood pressure readings. If so, follow those guidelines.
  • Swelling, redness and/or pain in one leg or arm and not the other (may be signs and symptoms of blood clot)
  • 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)

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

Axitinib Precautions:

  • Before starting axitinib 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.
  • Common drug interactions with Inlyta include dexamethasone (Decadron), St. John’s Wort (Hypericum perforatum).
  • Avoid grapefruit or grapefruit juice.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking axaxitinib. Barrier methods of contraception, such as condoms, are recommended.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.) 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 Inlyta, the medication must be stopped immediately and the woman given appropriate counseling).
  • Do not breast feed while taking axitinib.

Axitinib Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • 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).
  • Monitor your blood pressure as recommended by your physician. Call your doctor if you develop new high blood pressure or worsening of pre-existing high blood pressure.
  • You may be at risk of infection so wash your hands often.
  • Report fever or any other signs of infection immediately to your health care provider.
  • Be sure to take good care of your mouth and teeth. 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.
  • 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.
  • 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 While Taking Axitinib:

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

How Axitinib 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.   Therapies that target receptors are also known as monoclonal antibodies.  Angiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Axitinib is a targeted therapy that targets and binds to the vascular endothelial growth factor receptors (VEGFR) on the inside of cancer cells. VEGFR is found on the surface of many normal and cancer cells.  By binding to these receptors axitinib blocks an important pathway that promotes angiogenesis (making of blood vessels).

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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