Zynyz
Zynyz (retifanlimab) is an immunotherapy medication used to treat a type of anal cancer called squamous cell carcinoma of the anal canal (SCAC). It’s also FDA approved to treat a rare skin cancer called Merkel cell carcinoma (MCC). You receive it as an intravenous (IV) infusion at a cancer clinic or an infusion center, usually once every 4 weeks. This medication works by helping your immune system find and attack cancer cells, but it can also cause side effects like rash, diarrhea, or lung problems.
What is Zynyz (retifanlimab)?
What is Zynyz (retifanlimab) used for?
- Squamous Cell Carcinoma of the Anal Canal (SCAC)
- Taken with carboplatin and paclitaxel as a first-choice treatment of advanced cancer
- Taken alone if platinum‑based chemotherapy didn’t work or caused too many side effects
- Merkel cell carcinoma (MCC)
How Zynyz (retifanlimab) works
Zynyz (retifanlimab) 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.
Zynyz (retifanlimab) 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 | Zynyz |
|---|---|
| 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 Zynyz (retifanlimab)
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
SCAC with chemotherapy
- Reduced blood cell levels (up to 91%)
- Tingling sensation (56%)
- Diarrhea (49%)
- Muscle and bone pain (40%)
- Higher liver enzyme levels (up to 35%)
- Bleeding (29%)
- Rash (29%)
- Itching (24%)
SCAC alone
- Tiredness (42%)
- Reduced blood cell levels (up to 35%)
- Higher liver enzyme levels (up to 28%)
- Muscle and bone pain (27%)
- Diarrhea (23%)
- Infections (21%)
MCC
- Muscle and bone pain (37%)
- Tiredness (33%)
- Reduced blood cell levels (up to 31%)
- Higher liver enzyme levels (up to 28%)
- Itching (22%)
Less Common Side Effects
SCAC with chemotherapy
- Mouth sores
- Low thyroid hormone levels
- Changes in electrolyte levels
SCAC alone
- Fever
- Nausea
- Constipation
- Stomach pain
- Vomiting
- Urinary tract infection
- Bleeding
- Rash
- Itching
- Reduced appetite
- Shortness of breath
- Cough
- Headache
- Weight loss
MCC
- Fever
- Rash
- Diarrhea
- Nausea
- Constipation
Zynyz (retifanlimab) 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 Zynyz (retifanlimab) 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 Zynyz (retifanlimab)
Pros
- FDA approved for MCC and SCAC
- Doses are given over only 30 minutes once every 4 weeks
- Can be used alone or with chemotherapy
Cons
- Given as an IV infusion by a healthcare professional
- Can cause immune-related side effects like diarrhea, rash, and lung problems
- Careful monitoring and lab testing are required
Pharmacist tips for Zynyz (retifanlimab)
- Put your Zynyz (retifanlimab) infusion appointments on your calendar. You’ll usually get infusions every 4 weeks. If you miss an appointment, call the clinic right away to reschedule.
- Get your lab tests done as your oncologist recommends while taking Zynyz (retifanlimab). 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 Zynyz (retifanlimab). 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 Zynyz (retifanlimab) 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 Zynyz (retifanlimab), don’t stop them suddenly. Your oncologist will give you a plan to slowly lower the dose to avoid symptoms.
- Get medical help right away if you have an infusion-related reaction with Zynyz (retifanlimab). Symptoms can include chills, shaking, rash, trouble breathing, dizziness, fever, or back or neck pain.
- If you can get pregnant, use reliable birth control while taking Zynyz (retifanlimab) 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.
- Don’t breastfeed while taking Zynyz (retifanlimab) 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 Zynyz (retifanlimab)
Zynyz (retifanlimab) 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 Zynyz (retifanlimab) 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 Zynyz (retifanlimab). 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 may 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 Zynyz (retifanlimab) 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 Zynyz (retifanlimab) and have had a stem cell transplant can have serious side effects. This can include liver damage called veno-occlusive disease (VOD). It can also lead to graft-versus-host disease (GVHD).
Before starting Zynyz (retifanlimab), 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 Zynyz (retifanlimab) works, this medication could cause harm to an unborn baby. If you’re able to get pregnant, use effective birth control while taking Zynyz (retifanlimab) and for 4 months after your last dose.
Zynyz (retifanlimab) dosage
Typical dosage for Zynyz (retifanlimab)
The typical dose is 500 mg given as an intravenous (IV) infusion once every 4 weeks.
What are alternatives to Zynyz (retifanlimab)?
Zynyz (retifanlimab) images
