Axatilimab-csfr (Niktimvo™)
Pronounce: AX-a-TIL-i-mab
Classification: Monoclonal antibody
About Axatilimab-csfr (Niktimvo™)
An antibody is a protein made by your body to help your immune system find and stop bacteria and viruses from attacking your body. A monoclonal antibody is an antibody made in a lab that can attach to certain cancer cells in your body. Your immune system then attacks and kills the cancer cell that it is attached to. Monoclonal antibodies work with your immune system to kill cancer cells by:
- Helping your immune system attack the cancer cells.
- Blocking growth of the cancer cells.
- Blocking other things the cancer cells need.
Ask your provider about the type of monoclonal antibody you are taking and how it works.
Axatilimab-csfr is directed against colony-stimulating factor-1 receptors (CSF-1R), found on certain cells of the immune system. Axatilimab attaches itself to the CSF-1R to reduce pro-inflammatory immune cells which can lead to chronic graft versus host disease.
How to Take This Medication
Axatilimab-csfr is given by an intravenous (IV, into a vein) infusion. The amount given and schedule are based on your size. Make sure your care team is aware of all medications (including prescription and over-the-counter), supplements, and vitamins you are taking.
Possible Side Effects
These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.
Liver Toxicity
This medication can cause liver toxicity, or liver problems, which your provider may monitor for with blood tests called liver function tests. Symptoms may be:
- Yellowing of your skin or eyes.
- Dark or brown urine.
- Pain in your abdomen (belly).
Tell your provider if you have any of these symptoms.
Increased Infection Risk
Taking this medication can raise your risk of infections. You should report any new or worsening symptoms of infection to your healthcare provider right away, including a fever (temperature greater than 100.4°F or 38°C), sore throat or cold-like symptoms, shortness of breath, cough, burning or pain with urination, changes to your skin, or any new or worsening pain.
Muscle or Joint Pain/Aches and Headache
You may have joint or muscle pain/aches and headaches while taking this medication. Your provider can recommend medications and other ways to help relieve your pain.
Electrolyte Abnormalities
This medication can affect your electrolytes (potassium, magnesium, sodium, calcium, etc.). Your electrolyte levels will be checked with blood tests. If your levels get too low, you may be given electrolytes by IV (intravenously through your vein) or by mouth. Talk to your provider before taking any supplements.
Pancreas Problems
This medication can affect your pancreas. Call your provider if you have any symptoms of pancreatitis (inflammation of the pancreas), such as:
- Bloating,
- Indigestion.
- Nausea and/or vomiting.
- Fatty stools (that are bulky, pale, oily, and sometimes float).
- Not feeling hungry (loss of appetite).
- Sweating.
- Abdominal (belly) pain or swelling.
- Weight loss.
Your provider may monitor certain blood levels with labs during and after treatment.
Fatigue
Fatigue can cause exhaustion, feeling worn out and that your body is "heavy" and hard to move, or being unable to focus. It is common when you have cancer, and it is not the same as feeling tired. You may need to adjust your schedule to manage fatigue. Plan times to rest during the day and save your energy for more important activities. Exercise can help lessen fatigue. Talk to your providers about ways to deal with this side effect.
Nausea and/or Vomiting
Talk to your providers if you have nausea and/or vomiting. They can prescribe medications to help you. Making changes to your diet can also help. Avoid things that make your symptoms worse, like heavy or greasy/fatty foods and spicy or acidic foods, like tomatoes, lemons, and oranges. Try saltines or ginger ale to help your symptoms.
Call your providers if you cannot keep fluids down for more than 12 hours or if you feel lightheaded or dizzy.
Reproductive Concerns
There is a higher risk of health problems for your baby if you are pregnant, become pregnant, or get someone pregnant while on this medication. To lower the risk of birth defects, you should use birth control (contraception) to avoid pregnancy. Talk with your provider about what kind of birth control is safest for you and your partner.
If you can become pregnant, you will need to use effective birth control during treatment and for 30 days after the last dose of this medication, even if your menstrual cycle has stopped or changed.
If you can get someone pregnant, you will need to use effective birth control during treatment and for 30 days after the last dose of this medication, even if you believe you are not producing sperm.
You should not breastfeed during treatment and for 30 days after the last dose of this medication.
Fertility
This medication may affect your fertility. It can cause changes to your menstrual cycle or sperm. You may want to consider sperm banking or egg harvesting if you might wish to have a child in the future. Talk about your options with your provider before treatment.
Important but Less Common Side Effects
Infusion-Related Side Effects
Some people may have a reaction during infusion of this medication. These can be:
- Chills.
- Fever.
- Low blood pressure.
- Nausea.
- Vomiting.
Your provider will monitor you for symptoms of infusion-related reactions.