Why is this medication prescribed?

Yescarta (axicabtagene ciloleucel) is a prescription medication used in the treatment of certain types of non-Hodgkin lymphoma (NHL), specifically diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL). It is a type of chimeric antigen receptor (CAR) T-cell therapy, which involves modifying a patient’s own T cells to express a receptor that targets cancer cells.

How should this medicine be used?

Here’s an overview of why and how Yescarta is prescribed:

• Indication: Yescarta is indicated for the treatment of adult patients with relapsed or refractory DLBCL and PMBCL after at least two prior systemic therapies.
• Mechanism of Action: Yescarta is a form of immunotherapy. The treatment involves collecting the patient’s T cells, genetically modifying them to express a CAR that targets CD19, a protein found on the surface of certain cancer cells, and then infusing these modified cells back into the patient. The CAR T cells are designed to recognize and attack cancer cells expressing CD19.
• Administration: Yescarta is administered as a one-time infusion. The entire process involves several steps:
  • Collection of the patient’s T cells.
  • Genetic modification of T cells in a laboratory to express the CAR.
  • Expansion of the modified CAR T cells.
  • Infusion of the Yescarta product back into the patient.
• Patient Evaluation: Patients are carefully evaluated before receiving Yescarta to ensure they meet specific criteria. This evaluation includes assessments of overall health, cardiac and pulmonary function, and the absence of active infections.
• Potential Side Effects: Yescarta treatment can be associated with serious side effects, including cytokine release syndrome (CRS) and neurologic toxicities. Monitoring for and managing these side effects is a crucial part of the treatment process.
• Specialized Centers: The administration of Yescarta is typically performed in specialized medical centers with experience in CAR T-cell therapy due to the complexity of the treatment and the potential for severe side effects.
• Follow-Up: After the infusion, patients are closely monitored for potential side effects and response to treatment. Long-term follow-up is also important to assess the durability of the treatment response.

It’s important to note that the information provided here is a general overview, and individual patient experiences may vary. Patients considering or undergoing Yescarta treatment should discuss their specific situation, potential risks, and benefits with their healthcare team.

Other uses for this medicine

Yescarta (axicabtagene ciloleucel) is primarily indicated for the treatment of certain types of non-Hodgkin lymphoma, specifically relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL) after at least two prior systemic therapies. Clinical indications for medications can evolve, so it’s essential to consult the most recent medical literature or your healthcare provider for the latest information.

What special precautions should I follow?

Regarding special precautions, Yescarta is associated with unique considerations due to its nature as a CAR T-cell therapy. It’s crucial to follow the guidance of healthcare professionals, and here are some general precautions associated with Yescarta:

• Patient Eligibility and Evaluation: Yescarta is generally prescribed for patients who have not responded to other treatments or have relapsed after previous therapies. Before receiving Yescarta, patients undergo a thorough evaluation, including assessments of overall health, organ function, and exclusion of active infections.
• Treatment Location: Yescarta is typically administered in specialized medical centers with experience in CAR T-cell therapy. This is because the administration process involves complex procedures, and healthcare providers at specialized centers are familiar with managing potential side effects.
• Monitoring and Side Effect Management: Yescarta treatment can lead to side effects such as cytokine release syndrome (CRS) and neurologic toxicities. Close monitoring is essential during and after treatment. Healthcare providers will have protocols in place to manage and treat potential side effects promptly.
• Infections: Due to the impact of Yescarta on the immune system, there is an increased risk of infections. Patients may be advised to take precautions to avoid infections, and healthcare providers will monitor for signs of infections during and after treatment.
• Educating Patients and Caregivers: Patients and caregivers should receive thorough education about potential side effects, the importance of monitoring, and when to seek medical attention. This includes recognizing symptoms of CRS, neurologic issues, or infections.
• Long-Term Follow-Up: Long-term follow-up is critical to assess the durability of the treatment response and to monitor for late effects or potential relapses.
• Pregnancy and Breastfeeding: The safety of Yescarta during pregnancy and breastfeeding is not well established. Patients are advised to discuss family planning with their healthcare team, and appropriate precautions are taken to avoid pregnancy during and after treatment.

It’s essential to note that the information provided here is a general overview, and specific precautions may vary based on individual patient characteristics and evolving medical guidelines. Patients considering or undergoing Yescarta treatment should have open and detailed discussions with their healthcare team to understand the specific precautions and recommendations tailored to their situation.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Yescarta. However, it’s important to maintain a healthy and well-balanced diet to support your overall well-being and help your body recover from the treatment. Stay hydrated and focus on a diet that includes a variety of fruits, vegetables, lean proteins, and whole grains.

What should I do if I forget a dose?

Yescarta is administered as a one-time infusion, so there is no concern about forgetting a dose. The treatment plan is carefully coordinated, and the infusion is typically done in a hospital or clinical setting under the supervision of healthcare professionals.

What side effects can this medication cause?

Yescarta (axicabtagene ciloleucel), like other chimeric antigen receptor (CAR) T-cell therapies, can cause a range of side effects. It’s important to note that the severity and occurrence of these side effects can vary among individuals. Some common side effects include:

• Cytokine Release Syndrome (CRS): CRS is a common side effect of CAR T-cell therapies. It occurs when the infused CAR T cells become activated and release a large amount of cytokines, leading to symptoms such as fever, fatigue, nausea, muscle aches, and in severe cases, low blood pressure and organ dysfunction.
• Neurologic Toxicities: Yescarta can cause neurologic side effects, which may include confusion, difficulty speaking or understanding speech, seizures, and other cognitive impairments. These symptoms can range from mild to severe.
• Low Blood Cell Counts: Yescarta can lead to a decrease in red blood cells, white blood cells, and platelets. This may result in anemia, neutropenia (lowered white blood cell count), and thrombocytopenia (lowered platelet count).
• Infections: As Yescarta affects the immune system, patients may be more susceptible to infections. Serious infections can occur and may require treatment with antibiotics or antiviral medications.
• Febrile Neutropenia: Yescarta treatment may lead to fever associated with low white blood cell counts (febrile neutropenia), which can increase the risk of infections.
• Hypogammaglobulinemia: Yescarta may cause a decrease in immunoglobulin levels, which can affect the body’s ability to fight infections. Patients may need immunoglobulin replacement therapy.
• Hypotension: Low blood pressure can occur as a result of cytokine release syndrome or other factors. In severe cases, this may require medical intervention.
• Tumor Lysis Syndrome (TLS): TLS is a rare but potentially serious complication that can occur when cancer cells release their contents into the bloodstream faster than the body can eliminate them. This can lead to metabolic imbalances.
• Liver Enzyme Elevation: Yescarta may cause an increase in liver enzymes, which can be monitored through blood tests.

It’s important for patients receiving Yescarta to be closely monitored during and after treatment for the development of these side effects. Healthcare providers are experienced in managing and treating these side effects, and interventions can be implemented to address specific symptoms.

Patients are encouraged to report any new or worsening symptoms to their healthcare team promptly. The information provided here is a general overview, and specific side effects and their management may vary based on individual patient characteristics and medical guidelines. Patients should discuss potential side effects and management strategies with their healthcare providers before starting Yescarta treatment.

What should I know about storage and disposal of this medication?

Here are general guidelines for the storage and disposal of Yervoy:

• Storage:
  • Refrigeration: Yescarta is typically stored in a healthcare facility, and it is usually supplied frozen. It needs to be stored in a freezer at a specific temperature until it is ready to be administered.
  • Transportation: During transportation, Yescarta must be kept at a specific temperature to maintain its stability. Follow the guidelines provided by the healthcare facility or manufacturer.
• Disposal:
  • Disposal by Healthcare Providers: Healthcare providers are responsible for disposing of any unused or expired Yescarta in accordance with local regulations and guidelines.
  • Follow Local Regulations: Local regulations may vary regarding the disposal of biological waste or medications. Ensure that disposal is carried out in compliance with local guidelines to prevent environmental contamination.

In case of emergency/overdose

In case of emergency/overdose of Yescarta:

• Contact Healthcare Provider: In the case of an emergency or suspected overdose, contact your healthcare provider or seek medical attention immediately.
• Monitoring for Side Effects: Yescarta can cause various side effects, and it’s important to be vigilant for signs of adverse reactions. Follow the instructions given by your healthcare provider for monitoring and reporting side effects.

What other information should I know?

• Pre-treatment Evaluation: Before receiving Yescarta, patients usually undergo a thorough evaluation to assess their eligibility and potential risks. This may include tests to check organ function and overall health.
• Monitoring After Treatment: Patients receiving Yescarta are often monitored closely after treatment for potential side effects and complications. Follow-up appointments are important to assess the patient’s response to the therapy.
• Educational Resources: Healthcare providers often provide patients with educational materials and information about potential side effects, what to expect during and after treatment, and how to manage any complications.
• Patient Support Programs: Some pharmaceutical companies offer patient support programs that provide information, resources, and assistance with various aspects of treatment, including financial support.

Always consult your healthcare provider for personalized advice based on your medical condition and the most recent prescribing information for Yescarta. If you have specific questions or concerns, do not hesitate to reach out to your healthcare team for guidance.