Uses of Dinutuximab

Monoclonal antibodies are created in the laboratory to attach to targets found on specific types of cancer cells. The antibody "calls on" the immune system to attack the cell it is attached to, stimulating the immune system to kill the cancer cell. These antibodies can act in a variety of ways, including stimulating the immune system to kill cells, stop cell growth, or other functions necessary for cell growth.
Dinutuximab is a mouse crystalline monoclonal antibody targeted against GD2. GD2 is a disialoganglioside present in tumors of neurogenic origin, such as neuroblastoma and human melanoma. When bound to GD2, the drug Dinutuximab induces antibody-mediated cytotoxicity and tumor cell-dependent cytotoxicity. This leads to apoptosis and inhibits tumor growth.

Dinutuximab is indicated in combination with granulocyte colony-stimulating factor (GM-CSF), interleukin-2 and 13-cis-retinoic acid for the treatment of pediatric patients at high risk for neuroblastoma who have a single response. with previous polytherapy. However, complete treatment of neuroblastoma is rarely achieved, and the majority of patients relapse. Current strategies include immunotherapy (such as dinutuximab) to treat residual tumor cells and limit recurrence.

Dinutuximab is given intravenously, this drug can be combined with other chemotherapy. Actual dosage is based on patient's weight. Intravenous fluids will be given prior to infusion of Dinutuximab. Antihistamines and antipyretics will be given prior to infusion to prevent the infusion reaction of Dinutuximab . Pain medication will be given before the infusion begins, during the infusion, and for two hours after the infusion is completed.

During treatment with Dinutuximab medicine, you may experience the following undesirable effects:
Allergic reactions: In some cases, patients may be allergic to this medicine. Signs may include: fever, swelling of the face or lips, rash, trouble breathing, lightheadedness or dizziness within 24 hours of the infusion. If you notice any changes during your infusion, tell your doctor right away.
Severe pain and peripheral neuropathy (numbness or tingling in the hands and/or feet): peripheral neuropathy is a toxic disease affecting the nerves. It causes numbness or tingling in the hands and feet, usually when wearing gloves or socks. Dinutuximab may cause neuropathic pain during and after the infusion. The patient will be given analgesia before the infusion, continuously during the infusion, and for two hours after the infusion is completed. This pain may get worse with additional doses of the drug. In some people, symptoms slowly go away after stopping the medication, but for some, it never goes away completely. You should tell your doctor if you experience numbness or tingling in your hands and feet, as an adjustment in the dose of the medicine may be needed.
Capillary leak syndrome is a condition in which blood and blood components leak out of vessels and into body cavities and muscles. Movement of fluid out of the vessels can cause hypotension and organ failure. Signs and symptoms of leaky capillary syndrome include: sudden drop in blood pressure, dizziness, weakness, fatigue, sudden swelling of hands and feet, nausea. If you have any of these symptoms, tell your doctor right away.
Electrolyte disturbances: Dinutuximab can cause electrolyte disturbances. You will have regular blood draws to monitor these electrolytes and measures will be taken to correct abnormal levels. Some signs and symptoms of electrolyte abnormalities include seizures, heart palpitations, and cramps.
Thrombocytopenia: Platelets help with blood clotting, so with thrombocytopenia, your high risk of bleeding increases. Tell your doctor if you have any bruising or excessive bleeding such as nosebleeds, bleeding gums, or blood in your stools or urine. Some measures to reduce the risk of bleeding:
Do not use a razor Do not play sports and contact activities that can cause injury or bleeding. Do not take aspirin, anti-inflammatory drugs (NSAIDs) such as Motrin/Advil (ibuprofen), Aleve (naproxen), Celebrex (celecoxib), .. Do not floss, toothpicks and use toothbrushes with Soft bristles for brushing teeth. Anemia: Your red blood cells are responsible for carrying oxygen to the tissues in your body. When your red blood cell count is low, you may feel tired or weak. You should tell your doctor if you experience shortness of breath, shortness of breath, or chest pain.
Nausea and/or vomiting: tell your doctor for a prescription to help control nausea and vomiting. In addition, dietary changes can reduce this problem. Avoid things that can worsen symptoms, such as heavy or greasy foods, spices, or acidic foods (lemons, tomatoes, oranges). Try salt water or ginger to ease symptoms.
Diarrhea: you can use medicines to relieve diarrhea. Also, try eating bland, low-fiber foods, such as steamed rice and boiled chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and nuts. Soluble fiber, found in some foods, helps to absorb fluids and help relieve diarrhea. Foods high in soluble fiber include: apple sauce, ripe bananas, canned fruit, boiled potatoes, white rice, white flour products, oatmeal, cream of rice, cream of wheat and potatoes fries. Drink 8-10 glasses of alcohol and caffeine-free water each day to prevent dehydration.
Leukopenia: white blood cells (WBCs) play an important role in fighting infections. During treatment, you may experience leukopenia, which increases your risk of infection. You should tell your doctor right away if you have a fever over 38°C, sore throat or cold, trouble breathing, cough, burning when urinating, etc. The measures below will help you limit infection. :
Washing hands with soap or sanitizer is the best way to prevent bacteria from entering. Do not gather in crowded places and contact sick people (cold, fever, cough, ...) When gardening, wear protective clothing including long pants, gloves, boots, hat. No contact with pet waste. Keep all cuts or scrapes clean. Shower daily and take care of your mouth regularly. Uncommon side effects:
Eye problems: Dinutuximab can cause eye nerve disorders. The infusion will be interrupted when there are any changes in vision, including dilated pupils or slow response to light. The infusion will be stopped if vision is lost. Urine retention/ Transverse myelitis : In rare cases, this medicine may cause inability to urinate and inflammation of the spinal cord. Promptly report numbness, tingling, burning, weakness, or inability to urinate to your doctor. Atypical hemolytic syndrome: Atypical hemolytic syndrome is a rare disease that affects kidney function and can cause kidney failure. Possterior reversible encephalopathy syndrome (PRES): In rare cases, this medication causes a neurological disorder called posterior reversible encephalopathy syndrome (PRES), also known as posterior reversible encephalopathy syndrome (PRES). post-rebound brain (RPLS). Symptoms of PRES/RPLS include headache, seizures, coma, confusion, blindness, and other visual and neurological disturbances. Reproductive problems: Exposure to this medicine can cause birth defects in your unborn baby, so you should not become pregnant or father a child while you are taking this medicine. Birth control is important during treatment with Dinutuximab. Even if your period stops or you believe you are not producing sperm, you may still be able to conceive and conceive.

Drug interactions can reduce the effect of drugs or increase toxicity. So, list all the medications you are taking (including prescription and nonprescription drugs, vitamins, supplements, ...) to your doctor. Drugs that may interact with Dinutuximab such as: Duloxetine, Levodopa, Risperidone, Aripiprazole, Aripiprazole lauroxil, Nicorandil, Furazolidone, Tranylcypromine, Phenelzine, Minaprine, ...

Reference source: oncolink.org