Anktiva
Anktiva (nogapendekin alfa inbakicept) is an immunotherapy used to treat early-stage bladder cancer called nonmuscle invasive bladder cancer (NMIBC). You receive it directly into your bladder through a catheter (intravesical infusion), along with another treatment called Bacillus Calmette-Guerin (BCG). Because the medication stays in your bladder, it doesn’t typically cause common immunotherapy side effects like skin rash or diarrhea. But it can cause frequent urination, blood in the urine, or fever.
What is Anktiva (nogapendekin alfa inbakicept)?
What is Anktiva (nogapendekin alfa inbakicept) used for?
- Adults with nonmuscle invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) who have already received BCG treatment, given together with BCG therapy
How Anktiva (nogapendekin alfa inbakicept) works
Anktiva (nogapendekin alfa inbakicept) is an immunotherapy. More specifically, it’s an IL-15 agonist, which means it turns on a protein called IL-15 in your immune system.
When you receive Anktiva (nogapendekin alfa inbakicept), it activates immune cells like natural killer (NK) cells and T cells. These cells then help your body find and attack cancer cells.
Drug facts
| Common Brands | Anktiva |
|---|---|
| Drug Class | IL-15 agonist |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Anktiva (nogapendekin alfa inbakicept)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Higher creatinine in blood (76%)
- Painful urination (32%)
- Blood in the urine (32%)
- Urinating more often (27%)
- Urgent feeling to urinate (25%)
- Urinary tract infection (24%)
- Increased potassium levels (18%)
- Muscle pain (17%)
- Chills (15%)
- Fever (15%)
Less Common Side Effects
- Tiredness
- Nausea
- Bladder irritation
- Diarrhea
- Urinating at night
The following Anktiva (nogapendekin alfa inbakicept) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Bladder irritation
- Increased need to urinate
- Pain or trouble when passing urine
- Red or dark brown urine
Pros and cons of Anktiva (nogapendekin alfa inbakicept)
Pros
- Helps attack cancer cells directly in the bladder
- Stays in the bladder so doesn’t typically cause immunotherapy side effects
- Recommended treatment option for certain people with bladder cancer
Cons
- Requires a catheter for administration
- Might cause pain when urinating
- Complex treatment schedule that may be difficult to keep track of
Pharmacist tips for Anktiva (nogapendekin alfa inbakicept)
- The schedule for Anktiva (nogapendekin alfa inbakicept) can be hard to follow. Write down your appointments or use a phone app to stay on track.
- After you get Anktiva (nogapendekin alfa inbakicept), your urine might look red for up to 24 hours, which is normal. Call your urologist or oncologist if it stays red longer than 24 hours.
- Tell your care team if you have pain or burning when you urinate after Anktiva (nogapendekin alfa inbakicept). Fever or body aches with this could be a sign of a urinary tract infection (UTI).
- Drink plenty of fluids after each dose of Anktiva (nogapendekin alfa inbakicept). This helps your body recover after treatment.
- On treatment days, try to hold Anktiva (nogapendekin alfa inbakicept) in your bladder for 2 hours before you urinate. Tell your care team if you can’t wait that long.
- Pregnancy: If you can become pregnant, use birth control during treatment with Anktiva (nogapendekin alfa inbakicept) and for 1 week after your last dose.
- Breastfeeding: It’s not known if it’s safe to breastfeed while getting Anktiva (nogapendekin alfa inbakicept). Talk to your care team before nursing during treatment.
Risks and warnings for Anktiva (nogapendekin alfa inbakicept)
Anktiva (nogapendekin alfa inbakicept) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of metastatic bladder cancer with delayed surgery
If you have carcinoma in-situ (CIS) that didn’t respond to BCG therapy, your risk of developing more serious bladder cancer that spreads to other parts of your body is higher. Because of this, your urologist or oncologist will closely check how well Anktiva (nogapendekin alfa inbakicept) is working.
If your cancer doesn’t fully go away, your care team may talk with you about bladder removal surgery (cystectomy). If this is the right option, it’s important to have the surgery as soon as possible to help prevent the cancer from spreading.
Anktiva (nogapendekin alfa inbakicept) dosage
Typical dosage for Anktiva (nogapendekin alfa inbakicept)
Induction (starting phase): The typical dose is 400 mcg, mixed with BCG, given into the bladder once a week for 6 weeks.
- If no cancer is found after this, you move to maintenance. If cancer is still there, you might repeat this 6-week phase one more time.
Maintenance dose: The typical dose is 400 mcg, mixed with BCG, once a week for 3 weeks at months 4, 7, 10, 13, and 19.
- If you still have no cancer by month 25, your urologist might recommend more treatments at months 25, 31, and 37.
