Detailed explanation of EPKINLY (icarelatumumab) instructions: an essential manual for safe medication use

Ikorituzumab for adult patients with follicular lymphoma (FL) who have relapsed or been refractory after two or more lines of systemic therapy

Mechanism of action:

Icrelatumumab is a humanized bispecific IgG1 antibody that is unique in that it can simultaneously target B cells. CD20 on T cells and CD3 on T cells. Unlike those monoclonal antibodies that only target a single receptor on lymphocytes, icarelatumumab has the ability to recognize and bind to two different targets, namely T on the cell surface. CD3receptor and CD20receptor on the surface of lymphoma cells and normal B lineage cells. With this property, icarelatumumab can promote the release of pro-inflammatory cytokines through selective T cell-mediated cytotoxic activity, thereby promoting the lysis of malignant B cells.

Medication method:

EPKINLY (icarelatumumab) is administered by subcutaneous injection. The recommended dosage regimen is: 1 cycle with increasing dose on 1 day0.16mg, day 80.8mg, day 15 and day 22days48mg; fixed dose per week from 2 to 3 cycles48mg; once every other week on days 4 to 9; once every four weeks on day 1 of subsequent cycles. The specific dosage needs to be adjusted according to the patient's condition and doctor's guidance.

Side effects:

Cytokine release syndrome (CRS): This is one of the most common serious side effects of icorelatumumab treatment, manifesting as fever, chills, hypotension and other symptoms. Severe cases may require hospitalization.

Immune effector cell-associated neurotoxic syndrome (ICANS): This syndrome may cause neurological symptoms such as headache, dizziness, confusion, and epileptic seizures, which requires close monitoring and prompt treatment.

Injection site reactions: Since icarelatumumab is administered by subcutaneous injection, some patients may experience reactions such as redness, swelling, pain, and itching at the injection site.

Blood system abnormalities: Blood system abnormalities such as leukopenia and thrombocytopenia may occur during treatment, increasing the risk of infection or bleeding.

Digestive system discomfort: including nausea, vomiting, diarrhea, stomach pain and other symptoms, which may affect the patient's daily life and nutritional status.

Other side effects: Fatigue, muscle and bone pain, fever, allergic reactions (such as rash, urticaria, difficulty breathing, etc.) may also occur.

Warnings and precautions:

Strictly follow the doctor's instructions: Patients must take medication according to the dosage and course of treatment instructed by the doctor, and are not allowed to make unauthorized adjustments.

Regular monitoring: Blood tests, imaging tests, etc. need to be performed regularly during treatment to evaluate efficacy and monitor side effects.

Prevention of infection: SinceEPKINLY may affect the immune system, patients need to strengthen personal hygiene to avoid infection.

Report symptoms promptly: Any discomfort or abnormal symptoms should be reported to a doctor immediately for prompt treatment.

Drug interactions:

Interacts with other anti-tumor drugs, immunomodulators and commonly used drugs (such as antibiotics, analgesics), affecting efficacy or increasing the risk of adverse reactions.

Medication for special populations:

For pregnant women, lactating women, the elderly and patients with serious underlying diseases, special caution is required when usingEPKINLY.

Reference materials:https://www.drugs.com/monograph/epcoritamab-bysp.html