Tevimbra
Tevimbra (tislelizumab) is an immunotherapy medication used to treat certain types of esophageal cancer and stomach cancer. It works by helping your immune system fight cancer. You can receive it alone or with chemotherapy. The medication is given as an intravenous (IV) infusion, usually once every 2 to 6 weeks, depending on your dose. Common side effects include tiredness, reduced appetite, and diarrhea.
What is Tevimbra (tislelizumab)?
What is Tevimbra (tislelizumab) used for?
- Advanced esophageal cancer
- Taken with platinum-based chemotherapy as a first-choice treatment
- Taken alone after having chemotherapy
- Advanced stomach cancer taken with chemotherapy as a first-choice treatment
How Tevimbra (tislelizumab) works
Tevimbra (tislelizumab) is an immunotherapy called a programmed death-1 inhibitor, or PD-1 inhibitor.
Some cancer cells use the programmed death-1 (PD-1) pathway to hide from the immune system, which lets the cancer keep growing.
Tevimbra (tislelizumab) blocks this pathway, helping your immune system recognize and attack cancer cells more effectively, which can slow or stop cancer growth.
Drug facts
| Common Brands | Tevimbra |
|---|---|
| Drug Class | PD-1 inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Tevimbra (tislelizumab)
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
- Rise in blood sugar (46%)
- Lower red blood cell count (45%)
- Lower white blood cell count (up to 43%)
- Changes in electrolyte levels (up to 34%)
- Rise in liver enzymes (up to 32%)
- Tiredness (28%)
- Muscle or bone pain (24%)
- Weight loss (23%)
- Cough (22%)
Note: The side effects listed above were reported in a study where Tevimbra (tislelizumab) was used alone to treat esophageal cancer.
Less Common Side Effects
- Fever
- Reduced appetite
- Constipation
- Nausea
- Diarrhea
- Stomach pain
- Low thyroid hormone level
- Rash
- Bleeding
Tevimbra (tislelizumab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious immune-related side effects: rash, blisters, skin peeling, diarrhea, trouble breathing, coughing, chest pain, severe stomach pain, mucus or blood in stool
- Serious reaction during infusion: chills, fever, itching, fast heartbeat, trouble breathing
The following Tevimbra (tislelizumab) 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
- Dry cough, shortness of breath or trouble breathing
- Eye pain, redness, irritation, or discharge with blurry or decreased vision
- Heart muscle inflammation—unusual weakness or fatigue, shortness of breath, chest pain, fast or irregular heartbeat, dizziness, swelling of the ankles, feet, or hands
- Hormone gland problems—headache, sensitivity to light, unusual weakness or fatigue, dizziness, fast or irregular heartbeat, increased sensitivity to cold or heat, excessive sweating, constipation, hair loss, increased thirst or amount of urine, tremors or shaking, irritability
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Kidney injury (glomerulonephritis)—decrease in the amount of urine, red or dark brown urine, foamy or bubbly urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pain, tingling, or numbness in the hands or feet, muscle weakness, change in vision, confusion or trouble speaking, loss of balance or coordination, trouble walking, seizures
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Bone, joint, or muscle pain
- Diarrhea
- Fatigue
- Loss of appetite
- Nausea
- Skin rash
Pros and cons of Tevimbra (tislelizumab)
Pros
- Recommended treatment option for esophageal cancer and stomach cancer
- Given once every 2 to 6 weeks
- Can be used alone or with chemotherapy
Cons
- Given as an IV infusion by a healthcare professional
- Can cause immune-related side effects that can be serious
- Careful monitoring and lab testing are required
Pharmacist tips for Tevimbra (tislelizumab)
- Put your Tevimbra (tislelizumab) infusion appointments on your calendar. You’ll usually get an infusion every 2 to 6 weeks. If you miss an appointment, call your clinic right away to reschedule.
- Your first Tevimbra (tislelizumab) infusion will take about 1 to 2 hours. After that, future infusions can be done over 30 minutes. The first dose is given more slowly so your care team can watch for infusion-related reactions.
- Get medical help right away if you have an infusion-related reaction with Tevimbra (tislelizumab). Symptoms can include chills, shaking, rash, trouble breathing, dizziness, fever, or back pain.
- Get your lab tests done as your oncologist recommends while taking Tevimbra (tislelizumab). These tests help your care team check for any problems that might come up.
- Tell your oncology care team right away if you notice any immune-related side effects while taking Tevimbra (tislelizumab). Watch for rash, itching, cough, trouble breathing, or diarrhea, since you might need treatment quickly.
- Don’t use over-the-counter medications to treat any side effects from Tevimbra (tislelizumab) without checking with your care team first. Some of these side effects often need steroid treatment, and common medications like loperamide might not help.
- If you need to take steroids to manage side effects from Tevimbra (tislelizumab), don’t stop them suddenly. Your oncologist will give you a plan to slowly lower the dose to avoid symptoms.
- Pregnancy: If you can get pregnant, use reliable birth control while taking Tevimbra (tislelizumab) and for 4 months after your last dose. This medication can harm an unborn baby, so tell your care team right away if you become pregnant.
- Breastfeeding: Don’t breastfeed while taking Tevimbra (tislelizumab) and for 4 months after your last dose. We don’t know if it passes into breast milk, and it could be unsafe for a baby.
Risks and warnings for Tevimbra (tislelizumab)
Tevimbra (tislelizumab) 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.
Immune-related side effects
Immunotherapy medications such as Tevimbra (tislelizumab) can cause immune-related side events. This happens when your immune system becomes too active and starts attacking healthy cells, not just cancer cells. These side effects can happen anywhere in your body and at any time while you're taking Tevimbra (tislelizumab). They can be mild or very serious.
Some side effects don’t cause symptoms you can feel and only show up on blood tests, such as liver or kidney problems. That’s why it’s important to get your lab work done on time, even if you feel well.
Other side effects cause symptoms you might notice, like diarrhea, rash, or trouble breathing. Tell your care team right away if you notice anything new or unusual. Depending on how severe your symptoms are, you might need to pause treatment or take a steroid to help you feel better.
Infusion-related reactions
Some people can have a reaction while getting a Tevimbra (tislelizumab) infusion. Your care team will watch you closely during treatment, but tell them right away if you feel itchy, warm, nauseous, have a fast heartbeat, or have trouble breathing.
In many cases, slowing down or pausing the infusion can help manage these reactions so you can continue treatment. If the reaction is severe, you might need to stop the medication.
Complications from stem cell transplants
- Risk factors: People who have received a stem cell (bone marrow) transplant
Some people who take immunotherapy medications like Tevimbra (tislelizumab) and have had a stem cell transplant can have serious side effects. This can lead to graft-versus-host disease (GVHD).
Before starting Tevimbra (tislelizumab), tell your oncologist if you’ve had a stem cell transplant in the past or plan to have one later. Your care team will monitor you closely for signs of these problems during and after treatment.
Harm to unborn baby
Based on animal studies and how Tevimbra (tislelizumab) works, this medication could cause harm to an unborn baby. If you’re able to get pregnant, use effective birth control while taking Tevimbra (tislelizumab) and for 4 months after your last dose.
Tevimbra (tislelizumab) dosage
Typical dosage for Tevimbra (tislelizumab)
Tevimbra (tislelizumab) is given as an intravenous (IV) infusion by a healthcare professional. How often you receive it depends on your dose:
- 150 mg: every 2 weeks
- 200 mg: every 3 weeks
- 300 mg: every 4 weeks
- 400 mg: every 6 weeks
What are alternatives to Tevimbra (tislelizumab)?
Tevimbra (tislelizumab) images
