Classification: Monoclonal Antibody
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.
Ipilimumab is given as an intravenous (IV) infusion over 90 minutes, every 3 weeks, for a total of 4 doses. The actual dose is based on your body size and will be determined by your healthcare provider.
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), and bowel perforation. 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/or holding the dose of ipilimumab.
Symptoms of colitis include cause abdominal pain, diarrhea, cramping and blood in the stool, with or without fever. Bowel obstruction can cause abdominal pain, constipation, bloating and cramping. 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. Report any rash or itching (pruritis), as these can become more severe and require treatment with corticosteroids.
While on cancer treatment 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 and see OncoLink's section on fatigue for helpful tips on dealing with this side effect.
Your oncology team can recommend medications to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and seeds. Soluble fiber is found in some foods that absorbs fluid and can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange and grapefruit sections, boiled potatoes, white rice and products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Drink 8-10 glasses on non-alcoholic, un-caffeinated fluid a day to prevent dehydration. Read Low Fiber Diet for Diarrhea for more tips.
Ipilimumab can affect your liver function and, in rare cases, has caused liver failure. Your oncology team will monitor your liver function with blood tests.
Ipilimumab can also, in rare cases, cause damage to motor and/or sensory nerves. Report any weakness in arms or legs or feelings of tingling and numbness or changes to your healthcare team right away.