Irinotecan Liposome (Intravenous)

Overview

When pancreatic cancer becomes metastatic, it commonly spreads to the liver and/or the abdominal cavity. However, pancreatic cancer may also spread to the bones, brain, lungs and other organs. If patients are diagnosed with pancreatic cancer before it has become metastatic, it should be treated with surgery and/or medication immediately. However, if the cancer has already become metastatic when the cancer is diagnosed, the patient may require different treatment.

When Irinotecan Liposome is administered to the patient and activated, it inhibits an enzyme known as topoisomerase I. When this enzyme is unable to function, the DNA of the cells is affected. As a result, they are unable to replicate. By preventing cells from replicating, Irinotecan Liposome can effectively stop the cancer from spreading further.

In addition to this, Irinotecan Liposome affects the cell's normal functioning and can allow the body to destroy existing cells. When this is applied to cancer cells, Irinotecan Liposome allows the body to destroy the cells and effectively remove cancer cells from the patient's body.

Although Irinotecan Liposome can be used as a monotherapy, it is most commonly prescribed to patients who have also been treated with the chemotherapy drug, Gemcitabine. When used in conjunction with other medications, Irinotecan Liposome can increase the success of treatment and can significantly slow the growth of cancer cells.

Whilst Irinotecan Liposome prevents cancer cells from replicating and enables them to be destroyed, it cannot only target these cells. As a result, healthy cells can sometimes be affected by Irinotecan Liposome too and this can lead to a number of side-effects occurring. Although the adverse effects associated with anti-cancer medications can be debilitating, the benefits of using Irinotecan Liposome are generally outweighed by the risks of developing side-effects.

Following treated with Irinotecan Liposome, as well as other medications, patients with metastatic cancer can have an increased quality of life and can live longer as a result of the treatment. Whilst Irinotecan Liposome is a relatively new form of treatment for pancreatic cancer, it has consistently inhibited the growth of cancer cells and, therefore, reduce the rate at which the cancer is able to spread further.

Conditions Treated

  • Metastatic pancreatic cancer

Type Of Medicine

  • Antineoplastic enzyme inhibitor

Side Effects

Although any type of medication can cause patients to develop side-effects, anti-cancer drugs are associated with a considerable number of adverse effects. Due to this, patients should discuss the possible side-effects of treatment with their physician prior to beginning treatment with Irinotecan Liposome. Often, healthcare practitioners can help patients to reduce the adverse effects associated with this medication.

Generally, side-effects are more likely to occur within a few hours or days of the medication being administered. Following this, side-effects may diminish until further treatment is administered. When patients are given Irinotecan Liposome, they may experience the following side-effects:

  • Decreased appetite
  • Thinning of the hair or hair loss
  • Loss or lack of strength
  • Weakness
  • Vomiting
  • Watering of the mouth
  • Weight loss
  • Tearing of the eyes
  • Stomach or abdominal pain
  • Runny nose
  • Feeling of warmth
  • Sneezing
  • Increased sweating
  • Stuffy nose

Although the above symptoms can be distressing, they may not require additional medical treatment. If the patient is coping well and the side-effects are relatively mild, medical intervention may not be required. However, if the above side-effects are severe, concerning and/or prolonged, patients should obtain medical advice.

In addition to this, patients should obtain immediate medical advice if they experience any of the following adverse effects whilst they're being treated with Irinotecan Liposome:

  • Confusion
  • Fainting, lightheadedness or dizziness
  • Decreased urination
  • Fast heartbeat
  • Diarrhea (severe)
  • Tarry, black stools
  • Dizziness
  • Unusual weakness or tiredness
  • Dry mouth
  • Wrinkled skin
  • Fainting
  • Thirst
  • Fever
  • Sunken eyes
  • Lightheadedness
  • Chest discomfort or pain
  • Rapid breathing
  • Chills
  • Pain in side or lower back
  • Confusion
  • Reddening of the skin, particularly around the ears
  • Cough
  • Itching, hives or a rash on the skin
  • Difficult or painful urination
  • Swelling or puffiness around the face, tongue, lips, eyes or of the eyelids
  • Pale skin
  • Shallow, rapid breathing
  • Nausea
  • Shortness of breath
  • Irregular or slow heartbeat
  • Difficulty with swallowing or breathing
  • Sore throat
  • White spots, ulcers or sores in the mouth
  • Chest tightness
  • Unusual bruising or bleeding

Furthermore, patients should seek medical attention if they experience any side-effects which are not listed above following treatment with Irinotecan Liposome.

Dosage

When patients are treated with Irinotecan Liposome, they may be given Fluorouracil and/or Leucovorin as well. If so, Irinotecan Liposome prior to either Fluorouracil or Leucovorin. In addition to this, patients may be given an antiemetic and corticosteroid thirty minutes before Irinotecan Liposome is administered. These medications can help to reduce the side-effects associated with the medication.

Generally, patients who are being treated for metastatic pancreatic cancer are given 70mg of Irinotecan Liposome per meter of body surface area. Using the patient's body surface area to calculate their dose of Irinotecan Liposome, rather than their age or weight enables physicians to use a more exact and effective dose of Irinotecan Liposome. In most cases, this dose will be administered every two weeks until the course of treatment is completed. However, every patient is examined individually and physicians may alter the patient's dose of Irinotecan Liposome, if it is necessary to do so.

As Irinotecan Liposome is administered via intravenous injection, patients will only be given this medication in a clinical setting, such as a treatment center or a hospital. Usually, Irinotecan Liposome is administered slowly and each dose will take at least ninety minutes to be delivered. As Irinotecan Liposome is injected into a vein, it will be administered by a healthcare practitioner and patients will not have to calculate or inject their own dose of medication.

Potential Drug Interactions:

Whilst some medicines can be taken at the same time, others should not be used alongside one another. Due to this, patients should not take or use the following medicines whilst they are being treated with Irinotecan Liposome:

  • Atazanavir
  • Measles Virus Vaccine, Live
  • Itraconazole
  • Mumps Virus Vaccine, Live
  • Ketoconazole
  • Rotavirus Vaccine, Live
  • Varicella Virus Vaccine
  • Rubella Virus Vaccine, Live

Similarly, the following medicines are not recommended for use alongside Irinotecan Liposome:

  • Adenovirus Vaccine
  • Smallpox Vaccine
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Telithromycin
  • Boceprevir
  • Rifampin
  • Carbamazepine
  • Nelfinavir
  • Cholera Vaccine, Live
  • Lopinavir
  • Saquinavir
  • Clarithromycin
  • Ritonavir
  • Cobicistat
  • Nefazodone
  • Conivaptan
  • Posaconazole
  • Fosphenytoin
  • Phenytoin
  • Idelalisib
  • Rifabutin
  • Indinavir
  • Influenza Virus Vaccine, Live
  • Rifapentine
  • Poliovirus Vaccine, Live
  • Typhoid Vaccine
  • St John's Wort
  • Voriconazole
  • Telaprevir
  • Yellow Fever Vaccine
  • Tipranavir

Patients should also be aware that Irinotecan Liposome could interact with over-the-counter medicines, supplements and vitamins. Due to this, patients should tell their physician if they are using any of these substances before they start receiving Irinotecan Liposome. Patients will also need to obtain medical advice before using any new medicines, vitamins or supplements once they have started receiving treatment with Irinotecan Liposome.

Warnings

If patients have any other existing health conditions or a history of certain conditions, it may affect their treatment for metastatic pancreatic cancer. Due to this, patients should disclose their full medical history to their physician before they begin treatment. The following conditions, in particular, may be relevant if treatment with Irinotecan Liposome is being considered:

  • Interstitial lung disease
  • Bowel blockage

The efficacy and safety of Irinotecan Liposome injections on the pediatric population has not yet been confirmed. As a result, this medication is only usually prescribed to adult patients and should not be given to children or infants.

When patients are being treated with Irinotecan Liposome, they will have regular consultations with their physician and regular blood tests to confirm that the medication is not having any unwanted effects.

Treatment with Irinotecan Liposome can temporarily lower the patient's white blood cell count and this may present an increased risk of developing an infection. In order to prevent this, patients should try to avoid people who they know are unwell. If patients develop any symptoms associated with an infection, such as fever, chills, hoarseness, cough, painful or difficult urination or pain in the side or lower back, they should seek immediate medical attention.

Irinotecan Liposome can cause some patients to experience severe diarrhea but patients should not any medications to treat this, unless they are prescribed by their doctor. If patients experience the following symptoms, they should obtain immediate medical treatment:

  • Persistent diarrhea or vomiting
  • Bloody or black stools
  • Symptoms of dehydration, such as faintness, lightheadedness or dizziness

Patients may experience a serious lung problem as a result of treatment with Irinotecan Liposome and should obtain urgent medical help if they experience the following symptoms:

  • Cough
  • Unexplained fever
  • Trouble breathing

If Irinotecan Liposome is administered to pregnant patients, it may cause harm to the unborn fetus. Similarly, if male patients impregnate a sexual partner whilst they are being treated with Irinotecan Liposome, it may cause the fetus to develop birth defects.

Female patients should use an effective form of birth control during treatment with Irinotecan Liposome and for at least one month after their final dose of medication. Male patients should use effective birth control during treatment and for at least four months after their final treatment with Irinotecan Liposome.

If patients become pregnant or impregnate a sexual partner whilst receiving treatment with Irinotecan Liposome or following treatment, they should inform their physician immediately.

Patients should not breastfeed during or following treatment with Irinotecan Liposome as the medication may be passed to the infant via the breast milk and could cause them harm. If patients have been treated with Irinotecan Liposome in the past, they should obtain medical advice before breastfeeding.

Some anti-cancer drugs can have a long-term effect on fertility. If patients plan to have children in the future or are unsure about having children, they should discuss this with their physician prior to their treatment commencing.

Irinotecan Liposome can cause some patients to exhibit a serious allergic reaction involving anaphylaxis. If patients are affected in this way, they will require emergency medical treatment. The symptoms of an allergic reaction may include:

  • Chest tightness
  • Fever
  • Chills
  • Wheezing
  • Difficulty breathing
  • Difficulty swallowing
  • Hives
  • Dizziness
  • Itching
  • Rash on the skin
  • Hoarseness
  • Swelling of the face, mouth or hands

Storage

Irinotecan Liposome vials should be stored in accordance with the manufacturer's instructions. Typically, Irinotecan Liposome should be kept refrigerated when unopened, but should not be frozen. Vials of Irinotecan Liposome will also need to be protected from the light.

As Irinotecan Liposome is only administered by a healthcare practitioner, patients should not be required to store this medication at home.

Summary

Whilst metastatic pancreatic cancer may be difficult to treat, Irinotecan Liposome can be used to prevent the disease from spreading further and to enable the patient's body to destroy existing cells. When used in conjunction with other medications, Irinotecan Liposome can slow the growth of cancer cells by a considerable amount and provide more time for the patient's body to remove existing cancer cells from the body. As a result, Irinotecan Liposome can increase the success of anti-cancer treatment and can prolong the patient's life.