Classification: Keratinocyte Growth Factor
About: Palifermin (Kepivance®)
Palifermin is a man-made version of a protein, naturally produced by the body, called keratinocyte growth factor (KGF). KGF stimulates the growth of tissues such as: skin and the lining of the mouth, stomach, and intestines. KGF also assists in the repair of the skin and gastrointestinal lining by stimulating cells to grow and develop. Palifermin, like the body's own KGF, is also able to stimulate these cells to grow and develop.
Mucositis is inflammation of the lining of the mouth and gastrointestinal tract (throat, stomach, and intestines), frequently seen in patients undergoing bone marrow or stem cell transplant. Severe mucositis often includes sores and ulcers in the mouth and GI tract, making it difficult or impossible to eat, drink, talk or swallow. Palifermin is used to decrease the chance of developing severe mucositis or to shorten the duration of severe mucositis in cancer patients receiving chemotherapy and radiation therapy, and undergoing autologous or allogeneic transplant.
Palifermin is not a cancer treatment, but a supportive care medicine. This means it is used to counteract the effects of cancer and its treatments.
How to Take Palifermin
Palifermin is given as an intravenous (IV, into a vein) infusion once a day, for 3 days, before starting chemotherapy/radiation therapy, and for 3 days after completion of chemotherapy. Palifermin should not be given on the same day as chemotherapy or radiation therapy.
This medication can interact with heparin. Your healthcare provider should rinse the intravenous line with saline prior to and after Kepivance administration.
Possible Side Effects of Palifermin
There are a number of things you can do to manage the side effects of palifermin. 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:
Taste and Tongue Changes
Some patients reported a feeling of thickening or tingling of the tongue, discoloration of the tongue, alteration in taste, loss or change in sensation in and around the mouth, and/or a numbness and tingling around the mouth. Ask your care team about nutritional counseling services if this interferes with eating.
Some patients may develop a rash, red, dry, or itchy skin. Use an alcohol free moisturizer on your skin and lips; avoid moisturizers with perfumes or scents. Your doctor or nurse can recommend a topical medication if itching is bothersome. If your skin does crack or bleed, be sure to keep the area clean to avoid infection. Be sure to notify your healthcare provider of any rash that develops, as this can be a reaction. They can give you more tips on caring for your skin.
Fever can be a side effect of this medication. Contact your care provider for a temperature of 100.4 or greater.
Peripheral edema is swelling of the extremities caused by retention of fluid. It can cause swelling of the hands, arms, legs, ankles and feet. The swelling can become uncomfortable. Notify your oncology care team if you are experiencing any new or worsening swelling.
This medication can cause liver toxicity, which your oncology care team may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or you have pain in your abdomen, as these can be signs of liver toxicity.
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. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication. This is fine.