Unituxin (dinutuximab) is an anti-GD2 monoclonal antibody. It’s used to treat advanced, high-risk neuroblastoma, which is a type of cancer that mostly affects children. Unituxin (dinutuximab) is infused through the veins daily for 4 days in a row during each treatment cycle. It's usually given along with other anticancer medications. Some of the most common side effects of Unituxin (dinutuximab) include pain and infusion-related reactions, such as rash and fever.
High-risk neuroblastoma that has improved or partially improved after first-choice treatments (chemotherapy, surgery, and radiation)
Unituxin (dinutuximab) is a monoclonal antibody that finds and attaches to the GD2 target. These are markers found on the surface of cells, including healthy cells. But neuroblastoma cells have a lot more of these markers
When Unituxin (dinutuximab) attaches to the cancer cells, it signals the immune system to destroy them.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Only need to receive infusion for 4 days of each cycle, up to 5 cycles total
Can improve overall survival in children with neuroblastoma
Must stay in the hospital to be monitored for infusion-related side effects, like swelling and breathing problems
Not safe in pregnancy or breastfeeding
You’ll likely be admitted to the hospital for Unituxin (dinutuximab) infusions. The length of the hospital stay depends on how long the infusion takes and how your body responds to the therapy, but usually lasts at least 4 days. Consider bringing a book, games, or something to help pass the time while you’re in the hospital
Make sure you know when you’ll need to be admitted to the hospital and mark the dates on your calendar so you can keep track of hospital admissions. This will help you anticipate when you might need to take time off work or schedule childcare for siblings, if needed.
Let your care team know right away if you have any breathing problems, swelling, or dizziness during the Unituxin (dinutuximab) infusion. These reactions can be serious and your provider will need to slow down your infusion and treat your symptoms right away.
Let your provider know right away if you have trouble urinating after receiving Unituxin (dinutuximab). This might be a side effect of some of the pain medications you're receiving. Your provider will ask you to stop taking them to see if this helps. But the problem still doesn't go away, they might ask you to stop Unituxin (dinutuximab) treatment because this might be a sign of nerve damage from this medication.
Unituxin (dinutuximab) can cause vision changes, including blurry vision and sensitivity to light. Usually, these side effects should get better after a couple of weeks. If not, your provider might ask you to stop Unituxin (dinutuximab) treatment to prevent further damage.
Receiving Unituxin (dinutuximab) raises your risk of developing an infection because it lowers your blood cell counts. Even after you leave the hospital, it’s important to wash your hands often and limit coming in contact with large crowds or people who might be sick. Consider wearing a face mask, especially if you will be in a crowded space. Contact your provider if you develop a fever, which can be a sign of an infection. It’s important that your care team treat an infection quickly.
You might bleed or bruise more easily because receiving Unituxin (dinutuximab) can lower platelet levels. Make sure you’re careful to avoid injuries. If you play any sports, discuss with your provider whether you should continue playing. If you fall or get seriously injured, get medical help right away so your care team can check for signs of bleeding inside the body.
To limit bleeding while receiving Unituxin (dinutuximab), use a soft bristle toothbrush while brushing teeth and an electric razor if shaving. Check with your provider if you should continue to floss because some people might be at higher risk of gums bleeding.
Unituxin (dinutuximab) 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.
Unituxin (dinutuximab) commonly causes infusion reactions. Reactions can happen during the infusion or up to 24 hours afterwards. Most of the time, these reactions are mild, but sometimes, these reactions can be serious and need more medical attention.To lower the risk of these reactions, your provider will give you medications before starting the infusion. You’ll stay in the hospital during the Unituxin (dinutuximab) infusions so that your care team can monitor you closely for symptoms. If you do have a reaction, your care team might stop the infusion to provide treatment and restart at a slower rate. But if your reaction is very serious, then your provider will likely ask you to stop Unituxin (dinutuximab) permanently. Notify your provider right away if you experience symptoms of infusion-related reactions including rash, swelling, or breathing problems.
Most people experience pain during Unituxin (dinutuximab) infusions. The pain is caused by Unituxin (dinutuximab) binding to nerve cells and pain fibers.This can affect many areas of the body, including the stomach, arms, legs, and nerves. To help with pain, your provider will give you medications, such as opioid pain medications, with Unituxin (dinutuximab) infusion. Sometimes, they might also slow the infusion to help. Pain also typically lessened with each cycle. But if the pain still isn’t controlled, your provider might recommend stopping this medication.
Unituxin (dinutuximab) can also cause transverse myelitis, which is inflammation of the spinal cord. This is very rare, but can lead to weakness of the legs or arm, pain, feelings of numbness or tingling, or inability to control urination. You should notify your provider right away if you have these symptoms because you’ll need to stop the medication.
Rarely, people have reported a very serious brain condition called posterior reversible encephalopathy syndrome (PRES) after receiving Unituxin (dinutuximab). This condition is caused by swelling and narrowing of blood vessels in the brain and leads to serious symptoms. Get medical help right away if you have sudden severe headaches, confusion, vision loss, or vision changes.
Some people taking Unituxin (dinutuximab) experienced capillary leak syndrome, a condition where fluids from blood vessels leak into the surrounding tissues. Your healthcare team will be monitoring your vital signs, how much fluids you drink, how much urine you make, and body weight closely while in the hospital. Notify your provider right away if you notice any swelling, feeling lightheaded, dizzy, or weak.
Though not a common side effect, some people have reported eye problems after starting Unituxin (dinutuximab). These changes include blurry vision, dilated pupils, vision changes, and sensitivity to light. These eye problems are usually temporary and get better on their own after about 4 days. But sometimes, they can also be permanent. Let your provider know right away if you notice vision changes because they might ask you to stop taking Unituxin (dinutuximab). Depending on how serious the vision problems are, your provider might restart Unituxin (dinutuximab) for you but at a lower dose.
Risk factors: Taking opioid pain medications
It’s very rare, but Unituxin (dinutuximab) can cause nerve damage and make it difficult for you to urinate or fully empty the bladder. If you have trouble urinating, your provider will likely ask you to slowly stop taking the opioid pain medications first to see if this helps, since they can also cause this side effect. If it doesn’t, your provider might recommend you stop taking Unituxin (dinutuximab).
Unituxin (dinutuximab) can cause low blood pressure. You will receive intravenous fluids before your Unituxin (dinutuximab) infusion to help prevent this from happening. Your healthcare team will be checking your blood pressure throughout the infusion to make sure it's within safe range. Let the team know if you feel symptoms of low blood pressure, such as dizziness, lightheadedness, or nausea. If your blood pressure is very low, your provider might need to slow down the rate of the infusion or stop the treatment altogether.
Unituxin (dinutuximab) can cause your red blood cells, white blood cells, and platelet counts to drop. This can raise your risk for anemia, serious infections, and bleeding or bruising. Your provider will monitor your blood counts through lab work. Let your provider know as soon as possible if you experience chills, fever, fast heartbeat, tiredness, or bleeding and bruising that doesn’t go away.
Some people have experienced changes in electrolyte levels after Unituxin (dinutuximab) infusions. Your provider will monitor your electrolyte levels daily with blood draws while you’re receiving infusions. Tell your provider if you notice any symptoms of electrolyte problems, such as fast or abnormal heartbeat or muscle cramps.
Unituxin (dinutuximab) can cause harm to unborn babies. If you’re able to become pregnant, your provider will have you do a pregnancy test before starting treatment. Use effective birth control while taking this medication and for at least 2 months after your last dose.
Your child’s oncologist will determine their dose based on your child’s body surface area (BSA), which takes into account their weight and height. This medication is typically given by a healthcare team in a clinic or hospital setting.
The typical dosing of Unituxin (dinutuximab) is 17.5 mg/m2 infused daily through the veins, over 10-20 hours. It’s given 4 days in a row, toward the beginning or middle of each 24- to 32-day cycle. Your child can receive this medication for a maximum of 5 cycles.
Your child’s provider will also prescribe other medications, such as granulocyte macrophage-colony stimulating factor (GM-CSF) and isotretinoin, with Unituxin (dinutuximab) treatment. In addition, they'll receive medications before and during each Unituxin (dinutuximab) infusion to help with side effects.
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