Pembrolizumab
This helps your immune system fight against the cancer and may improve your chances of responding to treatment. However, it’s important to be aware that Pembrolizumab can also cause side effects by activating your immune system, so your healthcare team will closely monitor you for any potential issues while you’re receiving treatment.
Administration
Pembrolizumab is typically administered via intravenous infusion in a hospital or clinic setting every 3 or 6 weeks, as determined by your healthcare provider.Potential Side Effects & Management
• Diarrhea: Increased bowel activity.
• Nausea: Managing this side effects can significantly impact quality of life during treatment.
• Fatigue: This treatment may cause fatigue or weakness, which can impact daily activities.
• Fever: Elevated body temperature. Stay hydrated and monitor your temperature. If you have a fever over 38.3°C, you should advise your medical team or go to the emergency department.
• Loss of Appetite: Treatment can impact appetite temporarily. Dietary changes may be suggested.
• Rash: Rash symptoms typically start within 2 to 4 weeks of treatment initiation but may also appear later, even after a few months.
• Pruritus (Itching): Skin irritation causing itching. Avoid scratching, keep skin moisturized, and use antihistamines or topical creams as directed.
• Skin Changes: Rash, sensitivity, discoloration; moisturizing and protective measures are recommended.
• Muscle or Joint Pain: Pain in muscles or joints may arise; notify your doctor for pain relief, especially if persistent.
• Immune-Related Colitis: Inflammation of the colon. Inform your healthcare provider if you experience persistent abdominal pain, diarrhea, or blood in stools.
• Diabetes Mellitus: Increased blood sugar levels. Monitor blood glucose levels regularly and follow dietary and medication recommendations from your healthcare provider.
• Hypophysitis: Inflammation of the pituitary gland. Seek medical attention if you experience severe headaches, vision changes, or hormonal imbalances.
• Hypothyroidism/Hyperthyroidism: Abnormal thyroid function. Follow up with your healthcare provider for thyroid hormone level monitoring and management.
• Immune-Related Hepatitis: Liver inflammation. Monitor liver function tests regularly and report any signs of jaundice or abdominal pain to your healthcare provider.
• Immune-Related Nephritis and Renal Dysfunction: Kidney inflammation and dysfunction. Stay hydrated and report changes in urination patterns or flank pain to your healthcare provider.
Immune-Related Pneumonitis: Lung inflammation. Seek medical attention immediately for symptoms such as cough, shortness of breath, or chest pain.
• Immune-Related Myocarditis: Inflammation of the heart muscle. Seek immediate medical attention for symptoms such as chest pain or shortness of breath.
• Immune-Related Myositis: Muscle inflammation. Inform your healthcare provider if you experience muscle weakness or pain.
• Immune-Related Pancreatitis: Inflammation of the pancreas. Report severe abdominal pain or digestive issues to your healthcare provider.
• Infusion Reactions: Reactions occurring during drug administration. Your healthcare team will closely monitor you during infusions for any signs of allergic reactions or infusion-related side effects.
When to Seek Medical Attention
As you begin your treatment with Pembrolizumab, it’s important to stay vigilant for any potential side effects related to your immune system. These side effects, known as immune-related adverse events (irAEs), can affect different parts of your body. If you notice any unusual symptoms, it’s crucial to seek medical help promptly.
Keep an eye out for symptoms like:
1. Diarrhea, Increased Stool Frequency, and Bloody Stool:
– Abnormal bowel movements characterized by loose or watery stools, more frequent bowel movements than usual, or the presence of blood in the stool.
– Recognizing Symptoms: Watch for frequent episodes of loose or watery stools, increased stool frequency, or the presence of blood.
2. Liver Function Test Elevations:
– Abnormal results in tests measuring liver function, indicating potential liver dysfunction or damage.
– Identifying Signs: Be aware of symptoms such as jaundice (yellowing of the skin and eyes), abdominal pain or swelling, dark urine, or pale-colored stools, which may indicate liver dysfunction.
3. Encephalitis:
– Inflammation of the brain, which can lead to various neurological symptoms.
– Recognizing Symptoms: Be vigilant for signs of inflammation in the brain, including severe headaches, fever, confusion, altered consciousness, seizures, or focal neurological deficits.
4. Endocrine Gland Problems (e.g., hypophysitis, adrenal insufficiency, hypopituitarism, hypo- or hyperthyroidism, decreases in serum corticotropin levels, and Cushing’s syndrome):
– Dysfunctions affecting various glands in the body responsible for hormone regulation, potentially leading to hormonal imbalances.
– Identifying Manifestations: Monitor for symptoms such as fatigue, weakness, weight changes, changes in appetite, mood swings, changes in heart rate, excessive sweating, or changes in menstrual cycles.
5. Infusion Reactions:
– Adverse reactions occurring during or after the administration of medication through intravenous infusion.
– Recognizing Signs: Pay attention to symptoms such as fever, chills, flushing, itching, rash, shortness of breath, wheezing, chest pain, palpitations, or swelling of the face, lips, tongue, or throat during or after infusion.
6. Nephrotoxicity, including Nephritis and Renal Failure:
Toxic effects on the kidneys leading to inflammation (nephritis) or impaired kidney function (renal failure).
– Identifying Symptoms: Look for signs of kidney dysfunction, such as changes in urine output, swelling in the legs, ankles, or around the eyes, fatigue, shortness of breath, confusion, nausea, or chest pain.
7. Pneumonitis:
– Inflammation of lung tissue, which can impair breathing and lead to respiratory symptoms.
– Recognizing Signs: Be alert for symptoms such as cough, shortness of breath, chest pain, fever, fatigue, loss of appetite, or unexplained weight loss.
8. Rash/Skin Reactions or Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN):
– Adverse reactions affecting the skin, ranging from mild rashes to severe conditions like SJS or TEN.
– Identifying Skin Changes: Watch for the development of rash, blisters, or lesions on the skin, mucous membranes, or eyes, which may progress rapidly and be accompanied by fever or flu-like symptoms.
9. Other Immune-Related Adverse Drug Reactions (e.g., episcleritis, uveitis, neuropathies, pancreatitis):
– Adverse reactions involving various immune-related conditions affecting different organs or systems in the body.
– Recognizing Symptoms: Be mindful of various symptoms associated with immune-related adverse reactions, including eye pain, redness, or vision changes; numbness, tingling, or weakness in the extremities; or abdominal pain radiating to the back.