As an immunotherapy drug, Tremelimumab has shown potential in the treatment of various cancers, but its side effects and usage specifications require great attention from patients and medical staff. Reasonable management of adverse reactions and compliance with medication procedures are the key to improving treatment effects.
Precautions and side effects of Tremelimumab
The side effects of Tremelimumab are mainly related to the activation of the immune system, and targeted management measures need to be taken in combination with specific symptoms.
Common adverse reactions and coping strategies
After using Tremelimumab, ≥20% of patients with hepatocellular carcinoma reported rash, diarrhea, fatigue, itching, musculoskeletal pain, and abdominal pain. Laboratory abnormalities include elevated AST (≥40%), elevated ALT, and decreased hemoglobin. Nausea, fatigue, and decreased appetite are common in patients with non-small cell lung cancer. Mild rash or diarrhea can be relieved by topical medication or dietary adjustment; if symptoms continue to worsen, medication should be suspended and corticosteroid treatment should be received.
Treatment of severe immune-mediated reactions
Tesitumumab may cause severe immune-related adverse reactions such as pneumonia, colitis, and hepatitis. Grade 2 pneumonia or colitis requires suspension of medication, and grade 3-4 requires permanent discontinuation of medication. If ALT/AST exceeds 8 times the upper limit of normal or total bilirubin ≥ 3 times in patients with hepatitis, treatment must be terminated. Life-threatening reactions such as myocarditis and exfoliative skin disease require immediate discontinuation of medication and initiation of multidisciplinary supportive treatment.
Liver function, serum creatinine, and skin condition should be monitored regularly during treatment, and abnormalities should be promptly intervened. Patients should record changes in symptoms and maintain close communication with the medical team.
Infusion sequence of Tremelimumab
Tesitumumab needs to be used in combination with other drugs, and the infusion sequence and time interval directly affect the efficacy and safety.
Infusion specifications for combined medication
When used in combination with durvalumab, tesitumumab should be infused first on the same day, followed by durvalumab infusion, with an interval of at least 60 minutes. If combined with platinum-based chemotherapy, the infusion order is: Tremelimumab → durvalumab → chemotherapy drugs. The first treatment cycle must strictly follow the 1-2 hour interval; if no infusion reaction occurs, the subsequent cycle can be shortened to 30 minutes.
Technical points of infusion operation
Tremelimumab needs to be infused through an intravenous route containing a 0.2μm filter for no less than 60 minutes. The diluted solution must be used within 24 hours and avoid freezing or light. The clarity of the solution must be checked before infusion, and it should be discarded if it is turbid or contains particulate matter. If chills, dyspnea, and other reactions occur during the infusion, it must be stopped immediately and evaluated whether to continue treatment.
Strictly following the infusion process can reduce the risk of complications. Patients must cooperate with medical staff throughout the process to avoid adjusting the infusion rate by themselves.
Drug interactions of Tremelimumab
The direct interaction between Tremelimumab and other drugs has not yet been clarified, but the combination regimen requires careful assessment of potential risks.
Synergistic risks of immunosuppressants and chemotherapy drugs
When Tremelimumab is used in combination with durvalumab and platinum chemotherapy drugs, the severity of immune-mediated reactions may be enhanced. During treatment, it is necessary to avoid the use of other immunomodulators or anticoagulants at the same time to prevent superimposed toxicity. If corticosteroids are needed to control adverse reactions, the dose should be adjusted gradually to avoid rebound effects caused by sudden discontinuation of the drug.
Comprehensive disclosure of patient medication history
Patients need to provide their doctors with detailed information about the drugs they are currently using, including prescription drugs, over-the-counter drugs, and health products. Patients who have received immunotherapy in the past or have chronic diseases (such as autoimmune diseases) may need to adjust the dose of Tremelimumab or extend the monitoring cycle. The medication regimen for special populations (such as hepatic and renal insufficiency) needs to be individualized.
Tremelimumab needs to be refrigerated at 2°C-8°C and avoid repeated freezing and thawing after opening. If fever, chest pain, or persistent fatigue occurs during treatment, seek medical attention immediately. Regular review of imaging and blood indicators can help to detect disease progression or treatment-related toxicity at an early stage.
Correctly understanding the characteristics of the drug and standardizing the medication process are the basis for maximizing the efficacy of Tremelimumab. Patients should actively participate in treatment decisions and cooperate with the medical team to complete the entire management process.
