What are the precautions for taking Ivonescimab injection?

Ivonescimab injection (Ivonescimab) is an innovative PD-1/VEGF bispecific antibody drug mainly used to treat non-squamous non-small cell lung cancer (NSCLC). When using ivocilimab injection, patients and healthcare professionals need to understand and follow a series of important precautions to ensure the safety and effectiveness of the treatment.

1. Preparation and evaluation before medication

1. Medical history inquiry: Before using ivocilimab, doctors should inquire about the patient's medical history in detail, especially the history of allergies, autoimmune diseases, and the functional status of important organs. It should be contraindicated in patients allergic to ivocilimab or any of its components.

2. Physical condition assessment: Patients need to undergo a comprehensive physical examination, including blood routine, liver and kidney function, thyroid function, etc., to evaluate whether they are suitable for ivocilimab treatment.

3. Pretreatment: Some patients may need to use anti-allergic drugs, such as antihistamines or glucocorticoids, before infusion of ivocilimab to reduce the risk of infusion reactions.

2. Administration method and dose adjustment

1. Administration method: Ivocilimab should be administered by intravenous infusion. The infusion time is usually 30-60 minutes, which is subject to the operation of the medical institution. Do not use intravenous bolus or rapid intravenous injection.

2. Dose adjustment: The dose of ivocilimab needs to be determined based on the patient's weight, condition and doctor's evaluation. The recommended dosage range is generally 3-10 mg/kg or 20 mg/kg administered every 2-4 weeks (specific doses vary by study). During treatment, the doctor may adjust the dosage based on the patient's response and tolerance.

3. Combined medication: When ivocilimab is used in combination with other drugs (such as chemotherapy drugs), evocilimab should be given first, and the other drugs should be given after an interval of at least 30 minutes.

3. Efficacy monitoring and adverse reaction management

1. Efficacy monitoring: The efficacy needs to be evaluated regularly during treatment, including imaging examinations, tumor marker detection, etc. At the same time, patients should pay close attention to changes in clinical symptoms and signs.

2. Adverse reaction management: Evocilimab treatment may cause a series of adverse reactions, including fatigue, rash, diarrhea, hypertension, etc. For most grade 2 and certain grade 3 and 4 immune-related adverse reactions, dosing must be suspended or permanently discontinued. For suspected immune-related adverse reactions, adequate evaluation should be performed to exclude other causes, and corticosteroid treatment and supportive care should be given as needed.

3. Special adverse reactions: Atypical therapeutic reactions may be observed, such as temporary tumor enlargement or the appearance of new lesions within the first few months of treatment, followed by tumor shrinkage. If the patient's clinical symptoms are stable or continuously reduced, even if there is preliminary evidence of disease progression on imaging, based on the judgment of overall clinical benefit, continued ivocilimab treatment may be considered until disease progression is confirmed.

4. Storage and infusion management

1. Storage conditions: Unopened evocilimab injection should be stored in a refrigerated environment at 2-8°C away from light, and freezing is prohibited. The prepared solution should be used within 6 hours.

2. Infusion management: The infusion of evocilimab should be performed by professional medical staff to avoid mixed infusion with other drugs. During the infusion, the patient's vital signs and adverse reactions should be closely monitored.

5. Medication precautions for special groups

1. Pregnant and lactating women: The safety of evocilimab in pregnant and lactating women has not been determined, so it should be used with caution, and whether to continue treatment should be decided after fully evaluating the risks and benefits.

2. Patients with hepatic and renal insufficiency: Patients with mild hepatic insufficiency do not need to adjust the dose, but there is no research data on patients with moderate or severe hepatic insufficiency. No dose adjustment is required in patients with mild or moderate renal impairment, but data are also lacking in patients with severe renal impairment.

3. Elderly patients: The safety of evocilimab does not show significant differences between elderly patients (>65 years old) and non-elderly patients (≤65 years old), and no dose adjustment is required for elderly patients.

Reference materials:https://www.akesobio.com/en/media/akeso-news/240908/