How to deal with adverse reactions caused by talatumumab_ Kanghule

Talatuzumab is mainly used for extensive-stage small cell lung cancer that has progressed after platinum-containing chemotherapy. It is a bispecific antibody drug developed by the American company Amgen. Talatumumab requires intravenous infusion and may cause adverse reactions such as cytokine release syndrome and must be used under professional medical supervision.

How to deal with adverse reactions caused by talatumumab

A variety of adverse reactions may occur when using talatumumab. The following are common adverse reactions and treatment measures.

Cytokine release syndrome (CRS)

CRS manifests as fever, hypotension, or dyspnea. Grade 1 reactions require suspension of administration and oral antipyretic drugs; Grade 2 reactions require hospitalization and monitoring, intravenous injection of dexamethasone or tocilizumab; Grade 3 or higher reactions require transfer to ICU, use of high-dose steroids and permanent discontinuation of the drug.

Neurotoxicity (including ICANS)

Symptoms include confusion, drowsiness, or disorientation. For grade 1, treatment should be suspended and observed; for grade 2, dexamethasone should be used and neurological function should be assessed daily; for grade 3 and above, the drug should be stopped immediately, brain imaging examinations should be performed, and severe supportive care should be given.

Cytopenia

When neutrophils are lower than 1.0×10^9/L or platelets are lower than 50×10^9/L, medication needs to be suspended and granulocyte colony-stimulating factor injected. Febrile neutropenia requires immediate use of broad-spectrum antibiotics and isolation if necessary.

Abnormal liver and kidney function

When ALT/AST rises more than 3 times the upper limit of the normal value, treatment needs to be suspended and hepatoprotective drugs should be given. When bilirubin is significantly elevated or creatinine clearance is <30 mL/min, drug metabolism risks need to be assessed and subsequent medication regimens adjusted.

The above treatment measures need to be guided by professional doctors, and patients are not allowed to adjust themselves to avoid affecting their own health.

Who needs to pay attention when using talatumumab?

Specific groups may face higher risks when using talatumumab, and the benefits and potential harms of treatment need to be strictly evaluated.

Pregnant and lactating women

Talatuzumab’s pharmaceutical ingredients may enter the fetus through the placenta and affect fetal development, so it is contraindicated in pregnant women. Breastfeeding women need to stop taking the drug for at least 2 months before resuming breastfeeding to avoid the transfer of talatumumab drug components through breast milk.

Patients with low immune function

Patients with AIDS and organ transplantation are prone to serious infections, and their immune status needs to be assessed before using talatumumab. If the CD4+T cell count is lower than 200/μL, it is recommended to give priority to other treatment options.

Patients with hepatic and renal insufficiency

Patients with severe hepatic insufficiency (total bilirubin >1.5 times normal value) or end-stage renal disease lack clinical data and need to use the drug with caution. Liver enzyme and creatinine levels need to be monitored weekly during treatment.

Elderly patients

Patients over 65 years old do not need to adjust the dosage, but due to decline in organ function, the risk of CRS or neurotoxicity is higher. It is recommended to extend the post-infusion monitoring time to 48 hours and strengthen home nursing support.

Before taking medication, it is necessary to fully inform the doctor of your past medical history and medication history to avoid increasing treatment risks due to individual differences.

Other precautions for talatumumab

In addition to adverse reactions and population restrictions, attention must be paid to drug interactions and operating specifications during the entire treatment with talatumumab.

Drugs must be reconstituted in strict proportions, and infusion equipment made of compatible materials must be used. The infusion time should be controlled within 1 hour to avoid causing acute reactions too quickly. Patients must be accompanied by a caregiver within 48 hours after the infusion to facilitate timely response to sudden symptoms.

Lung cancer patients need to maintain a balanced diet and properly supplement protein and vitamins. Perform daily breathing exercises to improve lung function and avoid exposure to smoke or polluted environments.