What is Yervoy: Uses, Warnings & Interactions
Yervoy is a human cytotoxic T-lymphocyte antigen 4 (CTLA-4) blocking antibody available as an IV infusion that can help treat skin cancer, kidney cancer, colorectal cancer, liver cancer, and non-small cell lung cancer (NSCLC). Yervoy can cause severe and fatal immune-mediated adverse reactions that can involve any organ system. If this occurs, it should be discontinued immediately and high-dose corticosteroid should be given. Since it is an IV infusion, patients are monitored in a healthcare setting for signs of reactions.
Yervoy overview
BRAND NAMES:
Yervoy
Generic Names:
Ipilimumab
Uses:
Treats cancer, including colon, rectum, skin, kidney, liver, and lung cancer. Also helps prevent melanoma from coming back after surgical removal.
Therapeutic Classes:
Antineoplastic Agent
Human cytotoxic T-lymphocyte antigen 4 (CTLA-4) blocking antibody
Forms:
Single-use vial for injection
How it’s taken:
By IV infusion
What is Yervoy used for?
Yervoy is a cancer medication that works by interfering with the growth and spread of cancer cells in the body. It is used to treat melanoma (skin cancer) that cannot be treated with surgery or has spread to other parts of the body. Yervoy is also used to prevent melanoma from coming back after surgery. Yervoy may be used in combination with nivolumab to treat certain types of kidney, colorectal, and liver cancers, as well as NSCLC.
Expert tips for using Yervoy
Yervoy is an IV infusion cancer treatment that is given every two to six weeks, depending on the indication. It is only approved in those ages 12 years and older.
Your healthcare provider will work with you to schedule your IV infusion appointments. It is important that you keep these appointments.
While getting IV infusions, you will be closely monitored, especially for your first dose. Immune-mediated adverse reactions can occur, and severe reactions will warrant discontinuing Yervoy permanently.
The most common side effects of Yervoy include fatigue, diarrhea, itching, rash, and colitis. Make sure to communicate with your healthcare provider if any of these side effects become too burdensome.
What form(s) does Yervoy come in
Single-use vial:
50 mg/10 mL
200 mg/40 mL
What are common Yervoy doses?
Unresectable or metastatic melanoma: 3 mg/kg every 3 weeks for 4 doses
Adjuvant melanoma: 10 mg/kg every 3 weeks for 4 doses, then every 12 weeks for up to 3 years; discontinue if there is disease recurrence or unacceptable toxicity
Advanced renal cell carcinoma or microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer: 1 mg/kg after nivolumab is given (on the same day) every 3 weeks for 4 doses, then nivolumab is given without Yervoy every 2 to 4 weeks
Hepatocellular carcinoma: 3 mg/kg after nivolumab is given (on the same day) every 3 weeks for 4 doses, then nivolumab is given without Yervoy every 2 to 4 weeks
Metastatic NSCLC: 1 mg/kg every 6 weeks (while nivolumab is given every 2 weeks or every 3 weeks with platinum-doublet chemotherapy)
Common Yervoy prescriptions
Yervoy
10ml of 50mg/10ml vialYervoy
40ml of 200mg/40ml vial
How to take Yervoy
Your healthcare provider will prescribe your dose and schedule. This medicine is given by IV infusion, through a needle placed in a vein. This medicine must be given slowly, so the needle must remain in place for at least 30 to 90 minutes.
You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine. You will be monitored for adverse effects.
Your doctor may give you other medicines (including steroid medicine) before you receive this medicine and during treatment to help prevent unwanted effects.
Missed dose: This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.
What to do if you miss a dose of Yervoy
Yervoy is given on a fixed schedule by an IV infusion route. A dose may be missed if you are unable to show up to your appointment. If this happens, call your healthcare provider’s office and schedule an appointment as soon as possible. Your provider will guide your dosing based on when the dose was missed and how soon you can be seen.
Yervoy contraindications
This medicine is not right for everyone. You should not receive it if you have had a severe allergic reaction to ipilimumab or if you are pregnant or breastfeeding.
Yervoy warnings
Side effects of Yervoy include pain in the abdomen, diarrhea that may contain blood, fever, muscle pain, tenderness, weakness, lightheadedness, dizziness, or fainting.
Numbness, tingling, or burning pain in your hands, arms, legs, or feet may also occur.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
This medicine may cause the following problems:
Enterocolitis (swelling inside the bowels)
Liver problems
Serious skin reactions, including exfoliative dermatitis, Stevens-Johnson syndrome, drug rash with eosinophilia and systemic syndrome (DRESS), or toxic epidermal necrolysis
Nerve problems, which may lead to paralysis
Adrenal, pituitary, or thyroid gland problems
Changes in blood sugar levels
Other problems caused by the immune system, including pneumonitis (swelling of the lungs), nephritis (kidney inflammation), encephalitis (swelling of the brain), or eye or vision problems
Infusion reactions
Increased risk of possible organ transplant rejection
Yervoy may cause weakness, headaches, tiredness, weight changes, feeling unusually cold or hot, vomiting blood or material that looks like coffee grounds, or sores, ulcers, or white spots in your mouth or on your lips.
Yervoy interactions
Tell your healthcare provider if you have kidney disease, liver disease, or an autoimmune disease (including Crohn's disease, lupus, sarcoidosis, or ulcerative colitis), or if you have had a transplant.
Do not breastfeed during treatment and for at least three months after your last dose of this medicine.
It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant. Use an effective form of birth control during treatment and for at least three months after your last dose of this medicine.
Yervoy side effects
Your healthcare team will monitor you while you receive Yervoy. If a severe reaction occurs, they will be able to effectively treat it. This may include stopping Yervoy and administering high-dose corticosteroids.
Serious side effects:
Numbness, tingling, or burning pain in your hands, arms, legs, or feet
Increased hunger or thirst, dry mouth, sweating, or changes in how much or how often you urinate
Fever, chills, cough, sore throat, or body aches while receiving the infusion
Muscle pain, tenderness, or weakness
Vomiting blood or material that looks like coffee grounds
Chest pain, trouble breathing, swelling in your hands, ankles, or feet
Lightheadedness, dizziness, or fainting
Blurred vision, trouble seeing, eye pain, or other vision changes
Diarrhea that may contain blood
Weakness, headache, tiredness, weight changes, or feeling unusually cold or hot
Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, or yellow skin or eyes
Sores, ulcers, or white spots in your mouth or on your lips
Blistering, peeling, or red skin rash
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, or trouble breathing
Less serious side effects:
Pain, itching, burning, swelling, or a lump under your skin where the needle is placed
Constipation
Trouble sleeping
Skin rash or itching
Sources:
Highlights of prescribing information, Bristol-Myers Squibb Company (2020)
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