Classification: Monoclonal Antibody
Obinutuzumab is a synthetic (man made) antibody directed against a protein called CD20, found on the surface of normal and cancerous B-cells, which are part of the immune system. More than 90% of CLL cases affect the B cells, making this a good target for therapy. An antibody is a part of the immune system that "marks" things (such as germs, bacteria and, in this case, cancer cells) to be destroyed by the immune system. Once this medication attaches itself to the B cells expressing CD20, it summons the body's immune system to attack and destroy those cells.
Obinutuzumab is given by intravenous (into a vein) infusion. It may take several hours or longer to receive your first dose of obinutuzumab. Depending on how you tolerate the medication, you may receive subsequent doses more quickly.
You should not receive this medication if you have an active infection or have recently received a vaccine containing a live virus while on therapy (including oral polio, smallpox, MMR, nasal flu, and chickenpox vaccines).
There are a number of things you can do to manage the side effects of Obinutuzumab. 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:
Allergic or infusion reactions may occur during the first few treatments, and up to 24 hours after the infusion. You will be given diphenhydramine (Benadryl®), acetaminophen (Tylenol®) and an IV steroid before your treatment to reduce the chance of a reaction. During the infusion, if you experience difficulty breathing or swallowing, experience chest pain, “racing” heart, cough or wheezing, develop flushing or hives, lightheadedness, fever, chills, or shakes, inform your nurse immediately. Additional medications may be given to alleviate your discomfort. Your infusion may be slowed or temporarily stopped.
White blood cells (WBC) are important for fighting infection. While receiving treatment, your WBC count can drop, putting you at a higher risk of getting an infection. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4°), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.
Tips to preventing infection:
For more suggestions, read the Neutropenia Tip Sheet.
Platelets help your blood clot, so when the count is low you are at a higher risk of bleeding. Let your doctor or nurse know if you have any bleeding or excess bruising, including nose bleeds, bleeding gums or blood in your urine or stool. If the platelet count becomes too low, you may receive a transfusion of platelets.
Read the thrombocytopenia tip sheet for more information.
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. Even if your menstrual cycle stops or you believe your sperm is affected, effective birth control is necessary during treatment and up to 12 months after stopping treatment.
Rare, but serious side effects include: