Nogapendekin alfa inbakicept-pmln (Anktiva®)

Author: Katherine Okonak, LSW
Content Contributor: Christine Cambareri PharmD, BCPS, BCOP - Oncology Clinical Pharmacy Specialist
Last Reviewed: May 02, 2024

Pronounce: noe-GAP-en-DE-kin AL-fa in-BAK-i-sept

Classification: Biologic Response Modifier, Interleukin-15 (IL-15) receptor agonist

About: Nogapendekin alfa inbakicept-pmln (Anktiva®)

Nogapendekin alfa inbakicept-pmln works against cancer as a biologic response modifier targeting IL-15. Biological response modifiers are substances that have no direct antitumor effect but can trigger the immune system to attack tumors. This therapy is used with Bacillus Calmette-Guérin (BCG) – another biologic response modifier, to treat some cancers. When used with BCG, Nogapendekin alfa inbakicept-pmln activates the immune system causing inflammation of the bladder wall that, in turn, destroys cancer cells within the bladder.

How to Take Nogapendekin alfa inbakicept-pmln

Nogapendekin alfa inbakicept-pmln is given directly into the bladder (called intravesically) through a catheter. The medicine is left in the bladder for 2 hours, unless you are not able to retain it for that long, then it can be voided sooner. The dosage and schedule are determined by your healthcare provider. You may have red-tinged urine the first 24 hours after administration.

How the Intravesicular Treatment is Given

  • You should limit your fluid intake starting the night prior to the procedure and have no fluids for 4 hours before. This is so you will be able to hold your urine in during the procedure for the full treatment time. In addition, the area receives more concentrated (and effective) doses of the medicine with less urine output during the procedure.
  • If you take a diuretic (water pill), you will be told to not take this for at least 4 hours before the procedure.
  • A urinary catheter is inserted into the bladder and any urine is drained.
  • The medication is given through the catheter, into the bladder. The catheter may be removed or clamped and remain in place based on your provider’s recommendation.
  • You will need to hold the medication in your bladder for 2 hours. You may need to change positions every 15 minutes to be sure the medicine reaches all areas of the bladder. Do this by rolling on your side, back, other side, and stomach.

Precautions After Treatment

  • Try not to urinate for 1-2 hours after the procedure.
  • You should sit to urinate for 6 hours after the treatment to prevent splashing urine on the skin or exposing others to the medication.
  • Do not use public toilets or urinate outside.
  • For the first six hours after treatment, after each time you urinate:
    • Add 2 cups of household bleach to the toilet bowl and close the lid.
    • Wait 15-20 minutes and then flush the toilet with the lid down.
  • Wash your hands and genital area with soap and water after urinating to remove any traces of the medication from your skin and prevent skin irritation.
  • Drink plenty of fluids, starting after the first time you urinate and for 8-12 hours after your treatment to flush your bladder.
  • If you have urine incontinence, immediately wash your clothes in the washer. Do not wash with other clothes.
  • After using an incontinence pad, pour bleach on the pad, allow it to soak in, place it in a plastic bag, and discard it with trash.
  • Call your provider if you develop a fever (greater than 101.3° F/38.5°C) or shaking chills.

Possible Side Effects of Nogapendekin alfa inbakicept-pmln

There are a number of things you can do to manage the side effects of Nogapendekin alfa inbakicept-pmln. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Bladder and Urinary Problems

Therapy may cause side effects related to urination including pain urinating (dysuria), frequent urination, urgency to urinate (micturition), blood in urine (hematuria), and urinary tract infection. Symptoms of urinary tract infection include frequency, urgency, and burning with urination. It is less common, but Nogapendekin alfa inbakicept-pmln can also cause bladder irritation and frequent overnight urination (nocturia). These side effects can also affect your lab values like creatinine. You will have your labs drawn to monitor these values. If you’re having any of these symptoms, contact your provider right away.

Reproductive Concerns

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 1 week after your last dose, even if your menstrual cycle stops or you believe your sperm is affected. You should consult with your healthcare team before breastfeeding while receiving this medication.