Monjuvi
Monjuvi (tafasitamab or tafasitamab-cxix) is a monoclonal antibody that’s used as targeted therapy to treat a type of blood cancer called diffuse large B-cell lymphoma (DLBCL). It’s given as an infusion into the vein (intravenous or IV) at an infusion clinic or provider’s office. Monjuvi (tafasitamab) is often given together with another medication called lenalidomide (Revlimid). Side effects of Monjuvi (tafasitamab) include low blood cell counts, tiredness, and infusion reactions.
What is Monjuvi (tafasitamab)?
What is Monjuvi (tafasitamab) used for?
- Advanced diffuse large B-cell lymphoma (DLBCL) in adults who can’t get an autologous stem cell transplant; taken with lenalidomide (Revlimid)
How Monjuvi (tafasitamab) works
Diffuse large B-cell lymphoma (DLBCL) is a blood cancer that can happen when B lymphocytes (a type of white blood cell) start growing too quickly. Almost all B lymphocytes have a protein on their outside surface called CD19.
Monjuvi (tafasitamab) is a monoclonal antibody that targets the CD19 protein on B lymphocyte cancer cells. When the medication attaches to CD19 on these cancer cells, it tells the body to attack and kill the cell. As a result, the B lymphocyte cancer cells can’t grow or spread as well.
Drug facts
| Common Brands | Monjuvi |
|---|---|
| Drug Class | Anti-CD19 monoclonal antibody |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Monjuvi (tafasitamab)
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
- Low white blood cells (51%)
- Higher blood sugar (49%)
- Electrolyte changes in blood (up to 47%)
- Tiredness (38%)
- Diarrhea (36%)
- Anemia (low red blood cells, 36%)
- Low platelet levels (31%)
- Cough (26%)
- Fever (24%)
- Swelling in arms, legs, or feet (24%)
- Lower appetite (22%)
Less Common Side Effects
- Nausea
- Vomiting
- Stomach pain
- Back pain
- Muscle spasms
- Neutropenic fever
- Infection
- Rash
- Itching
Monjuvi (tafasitamab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Infusion-related reactions: fever, rash, chills, trouble breathing, flushing, high blood pressure
- Infection (from low white blood cell count): fever, chills, body aches, severe tiredness, fast heartbeat
- Bleeding (from low platelet levels): frequent nosebleeds, unexplained bruising, blood in urine or stool
The following Monjuvi (tafasitamab) 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
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Monjuvi (tafasitamab)
Pros
- Works in a more targeted, specific way than traditional chemotherapy
- Doesn’t typically cause hair loss
- Treatment option for people who aren’t eligible for an autologous stem cell transplant
Cons
- Requires several treatments per cycle, so less convenient
- Given as an infusion through the vein, so requires a needle for injection
- Might cause infusion reactions
Pharmacist tips for Monjuvi (tafasitamab)
- You’ll need several Monjuvi (tafasitamab) infusions per treatment cycle. You’ll also need to take an oral medication called lenalidomide (Revlimid) with Monjuvi (tafasitamab) for at least a year. It can be hard to keep track of your appointments and doses, so consider using a calendar or an app on your phone to help you remember.
- Monjuvi (tafasitamab) can cause infusion reactions, especially when you first start treatment. You’ll receive several pre-treatment medications, such as acetaminophen (Tylenol) and diphenhydramine (Benadryl), before each infusion to help prevent these reactions. If you tolerate your first three doses without any reaction, you might not need these “premedications” anymore.
- Monjuvi (tafasitamab) can raise your risk of getting sick. Make sure you wash your hands often and avoid crowds when possible during treatment with this medication.
- Check your temperature regularly, such as once a day. Call your provider right away if you have a temperature of 100.4 degrees Fahrenheit or higher. This means that you have a fever and might be sick, and it’s important for your provider to know if you’re sick.
- If you have diabetes, ask your provider whether you should check your blood sugar more often at home. Some people taking Monjuvi (tafasitamab) had higher blood sugar. Contact your provider if your blood sugar is higher than what’s normal for you.
- You shouldn’t breastfeed while you’re taking Monjuvi (tafasitamab) and for at least 3 months after your last dose. We don’t know whether this medication passes into human milk, but it’s possible that it might be able to harm a nursing infant.
Risks and warnings for Monjuvi (tafasitamab)
Monjuvi (tafasitamab) 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.
Infusion-related reactions
Some people taking Monjuvi (tafasitamab) experienced an infusion reaction. Most of the time, these reactions occurred during the first two treatment cycles. You’ll take several medications before your infusion to prevent a reaction. Symptoms of an infusion reaction can include fever, rash, chills, trouble breathing, flushing, and high blood pressure. Your nurse will closely keep an eye on you during your infusions. If you have a reaction, your provider might slow the speed of your infusion.
Low blood cell counts
Monjuvi (tafasitamab) might cause the number of blood cells in your body to drop, including your white blood cells, red blood cells, and platelets. When your white blood cells are low, you might get sick more easily because your body can’t fight infections as well. When your red blood cells are low, you might feel more tired. And when your platelets are low, your body can’t stop bleeding as well. Your provider will regularly check your blood cell counts with lab tests. Tell your provider if you feel very tired, have a fever, or have unusual bruising or nosebleeds; these can be signs of low blood cell counts.
Infection
When you have certain types of cancer such as lymphoma, your immune system doesn’t work as well. As a result, you’re at higher risk for getting sick. The risk is even higher when you take Monjuvi (tafasitamab) because the medication can lower your number of white blood cells, which normally help fight infection. People treated with Monjuvi (tafasitamab) have developed serious infections, including infections that usually only occur when the immune system is weak (also called opportunistic infections). Infections during treatment can sometimes be life-threatening.
Your provider will monitor you for infections, but you should also take steps to prevent infection and watch out for symptoms. Wash your hands often, wash raw fruits and vegetables before you eat them, and avoid large crowds. Be sure to check your temperature regularly, such as once per day. A fever is sometimes the only sign that you’re sick, so contact your provider immediately if you have a temperature of 100.4 degrees Fahrenheit or higher.
Harm to unborn baby
- Risk factors: Pregnancy
Monjuvi (tafasitamab) hasn’t been studied in human pregnancy. But based on the way the medication works, it might cause harm to an unborn baby when it’s taken during pregnancy. If you’re able to have children, you should use effective birth control while you’re taking Monjuvi (tafasitamab) and for at least 3 months after your last dose.
If you or your partner can become pregnant, you’ll also need to follow strict requirements regarding birth control and pregnancy tests when you’re taking Monjuvi (tafasitamab) with lenalidomide (Revlimid). This is because lenalidomide (Revlimid) is very harmful to unborn babies based on findings from animal studies.
Monjuvi (tafasitamab) dosage
Typical dosage for Monjuvi (tafasitamab)
Your provider will calculate your dose of Monjuvi (tafasitamab) based on your body weight. The typical dose is 12 mg/kg given as an intravenous infusion on certain days of a 28-day treatment cycle.
- Cycle 1: Days 1, 4, 8, 15, and 22
- Cycles 2 and 3: Days 1, 8, 15, and 22
- Cycles 4 and beyond: Days 1 and 15
You’ll take Monjuvi (tafasitamab) with another medication called lenalidomide (Revlimid) for up to 12 cycles. If you continue treatment after 12 cycles, you’ll take Monjuvi (tafasitamab) by itself.
What are alternatives to Monjuvi (tafasitamab)?
Monjuvi (tafasitamab) images
