Classification: Monoclonal Antibody
About Ipilimumab (Yervoy®)
Ipilimumab is a type of monoclonal antibody therapy, which works to stimulate the immune system to destroy cancer cells. T-cells are a type of white blood cell that are very important to the normal functioning of the immune system. Ipilimumab blocks the activity of cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), a molecule found on T cells that suppresses immune activity. By blocking CTLA-4, T-cells function better and the immune response is stimulated.
How to Take Ipilimumab
Ipilimumab is given as an intravenous (IV) infusion over 90 minutes. The actual dose is based on your body size and will be determined by your healthcare provider. Your provider will determine how many doses you should receive.
Make sure your care team is aware of all medications (including prescription and over-the-counter), supplements, and vitamins you are taking. Tell your care team about all your medical conditions.
Possible Side Effects of Ipilimumab
There are a number of things you can do to manage the side effects of Ipilimumab. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
Due to ipilimumab's activation of T-cells, the most common side effects are related to this immune response and include diarrhea, itchy skin (pruritis), rash, colitis (inflammation of the colon), bowel perforation, eye and hormone problems. All of these side effects can be very severe complications and can be fatal in rare cases. It is very important to report symptoms of these problems to your oncology team right away.
These reactions may be treated with corticosteroids (i.e. prednisone) and other medications and may require holding the dose of ipilimumab. The following are possible immune-mediated side effects and symptoms to report to your care team:
- Colitis: abdominal pain, diarrhea, cramping, mucus or blood in the stool, dark or tar-like stools, fever. Diarrhea means different things to different people. Any increase in your normal bowel patterns can be defined as diarrhea and should be reported to your healthcare team.
- Bowel obstruction or perforation: abdominal pain, fever, constipation, bloating and cramping.
- Skin reactions: report rash, with or without itching (pruritis), sores in your mouth, blistering or peeling skin, as these can become severe and require treatment with corticosteroids.
- Hepatitis and liver toxicity: jaundice (yellowing of skin or whites of the eyes), nausea, vomiting, abdominal pain, and bleeding or bruising. Your healthcare team will regularly monitor your liver function throughout the course or treatment.
- Eye problems: blurry or double vision, and changes in vision, eye pain or redness.
- Nerve problems: weakness of arms, legs or face, or numbness or tingling in the hands or feet.
Patients can experience immune-mediated reactions that affect the pituitary, thyroid and adrenal glands. These reactions can cause inflammation of these glands and affect their production of certain hormones. It is important that you report any changes in how you are feeling to your care team. Symptoms of these hormonal changes can include: headaches, nausea, vomiting, extreme fatigue, weakness, changes in memory and concentration, weight gain, dizziness, feeling cold all the time, and changes in mood or behavior (including irritability, forgetfulness and decreased sex drive).
Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment and for a period after. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should not breastfeed while receiving this medication.