What are common chronic lymphocytic leukemia (CLL) treatment side effects? Dr. Susan O’Brien, a Hematology-Oncology specialist, provides insight into common CLL treatment side effects and how they influence a treatment plan.

Dr. Susan O’Brien is an Associate Director of Clinical Sciences at the Chao Family Comprehensive Center at the University of Irvine.

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In this video, we dive into the essential facts about Calquence, a groundbreaking medication for treating blood cancers like CLL, SLL, and MCL. Learn how Calquence works, its benefits, potential side effects, and everything you need to know to make informed decisions about your treatment options

In this video, a Chelsey Gomez shares her experience with misdiagnosis and the need to advocate for herself. She experienced symptoms like fatigue and shortness of breath but was told it was stress. After a neck lump appeared, she was diagnosed with stage 2 Hodgkin's lymphoma and treated with ABVD chemo.

After several rounds of ABVD chemotherapy, she experienced life-threatening toxicity from the bleomycin drug, causing high fevers and landing her in the ICU. Despite suspecting it was the bleomycin, she had to advocate for herself and convince doctors it was a drug reaction rather than an infection.

She emphasizes the importance of listening to your body and speaking up when something seems wrong, especially for young patients.

Top Hodgkin's lymphoma expert Dr. Matthew Matasar joins her and shares how treatments have advanced from intensification to personalization to reduce toxicity.

What is Calquence medication?.
Calquence, also known by its generic name acalabrutinib, is a medication that belongs to a class of drugs called Bruton's tyrosine kinase (BTK) inhibitors. It was approved by the U.S. Food and Drug Administration (FDA) in 2017 for the treatment of certain types of lymphomas, including mantle cell lymphoma (MCL). Calquence is usually prescribed for patients who have not responded well to other treatments or who have experienced a relapse.
One of the key advantages of Calquence over other BTK inhibitors is its selectivity. Calquence specifically targets BTK, a protein involved in the growth and survival of cancer cells. By inhibiting BTK, Calquence disrupts the signaling pathways that contribute to cancer cell proliferation, leading to tumor regression and improved patient outcomes.
Benefits of Calquence medication.
Calquence offers several benefits for cancer patients, particularly those with mantle cell lymphoma. One of the primary advantages is its ability to inhibit cancer cell growth. By selectively targeting BTK, Calquence disrupts the signaling pathways that promote the survival and proliferation of cancer cells. This can lead to a reduction in tumor size and potentially even complete remission in some cases.

In addition to its anti-cancer properties, Calquence is generally well-tolerated by patients. It has a favorable safety profile compared to other BTK inhibitors, with fewer reports of severe adverse effects. This makes Calquence a viable treatment option for patients who may not tolerate or respond well to other medications.
How does Calquence medication work?.
Calquence works by specifically targeting and inhibiting Bruton's tyrosine kinase (BTK), a protein that plays a crucial role in the survival and proliferation of cancer cells. BTK is a key component of the B-cell receptor signaling pathway, which is essential for the growth and survival of B-cell lymphomas such as mantle cell lymphoma.
When BTK is activated, it triggers a cascade of signaling events that promote cancer cell growth and survival. Calquence binds to BTK, preventing its activation and inhibiting the downstream signaling pathways. This disrupts the growth and survival signals, leading to decreased cancer cell proliferation and increased cell death.
By specifically targeting BTK, Calquence minimizes the impact on healthy cells and reduces the risk of off-target effects. This selectivity is one of the key advantages of Calquence over other BTK inhibitors, as it allows for more effective and targeted cancer treatment.
Common uses of Calquence medication.
Calquence is primarily used for the treatment of mantle cell lymphoma (MCL), a rare and aggressive type of non-Hodgkin lymphoma. It is usually prescribed for patients who have received at least one prior therapy and have not responded well to other treatment options.
In addition to MCL, Calquence is being investigated for its potential use in other types of lymphomas and leukemias. Clinical trials are currently underway to evaluate its efficacy and safety in patients with chronic lymphocytic leukemia (CLL), diffuse large B-cell lymphoma (DLBCL), and other B-cell malignancies.
It is important to note that Calquence should only be used under the supervision of a qualified healthcare professional. Your healthcare provider will assess your specific medical condition and determine if Calquence is the appropriate treatment option for you.
Potential side effects of Calquence medication.
Like any medication, Calquence can cause side effects. However, it is important to remember that not all patients will experience these side effects, and the severity can vary from person to person. It is crucial to discuss any concerns or potential side effects with your healthcare provider before starting Calquence treatment.
Some of the common side effects associated with Calquence include nausea, diarrhea, headache, fatigue, and muscle pain. These side effects are usually mild to moderate and can be managed with supportive care measures. It is important to stay well-hydrated and follow a balanced diet to help alleviate these symptoms.

"DISCLAIMER: The content of this video is for informational and educational purposes only. It should not be used as a substitute for medical consultation. You should always seek the advice of your doctor or healthcare professional before taking any medication or starting any treatment. Treatments and medications should be prescribed and supervised by a qualified medical doctor only. Individual results may vary and the effectiveness of any treatment mentioned in this video is not guaranteed. Do not self-medicate, if you have any health problems, it is important to seek medical help immediately.



"

Nicholas J. Vogelzang, MD, From the Comprehensive Cancer Centers of Nevada on Cabozantinib's (XL184) Effect on Bone Metastases

On January 22, 2021, the Food and Drug Administration approved the combination of nivolumab (Opdivo, Bristol-Myers Squibb Co.) and cabozantinib (Cabometyx, Exelixis) as first-line treatment for patients with advanced renal cell carcinoma (RCC).

Efficacy was evaluated in CHECKMATE-9ER (NCT03141177), a randomized, open-label trial in patients with previously untreated advanced RCC. Patients were randomized to receive either nivolumab 240 mg over 30 minutes every 2 weeks in combination with cabozantinib 40 mg orally once daily (n=323) or sunitinib 50 mg orally daily for the first 4 weeks of a 6-week cycle (4 weeks on treatment followed by 2 weeks off) (n=328).

The trial demonstrated a statistically significant improvement in progression-free survival (PFS), overall survival (OS) and confirmed overall response rate (ORR) for patients treated with nivolumab plus cabozantinib compared with those who received sunitinib. Median PFS per blinded independent central review (BICR) was 16.6 months versus 8.3 months; HR 0.51 (95% CI: 0.41, 0.64). Median OS was not reached in either arm; HR 0.60 (95% CI: 0.40, 0.89). Confirmed ORR per BICR was 55.7% and 27.1% in the nivolumab plus cabozantinib and sunitinib arms, respectively.

The most common adverse reactions (= 20%) in patients receiving the combination of nivolumab and cabozantinib were diarrhea, fatigue, hepatotoxicity, palmar-plantar erythrodysaesthesia syndrome, stomatitis, rash, hypertension, hypothyroidism, musculoskeletal pain, decreased appetite, nausea, dysgeusia, abdominal pain, cough, and upper respiratory tract infection.

The recommended dose is nivolumab 240 mg every 2 weeks (30-minute intravenous infusion) or 480 mg every 4 weeks (30-minute intravenous infusion) in combination with cabozantinib 40 mg orally once daily without food until disease progression or unacceptable toxicity.

View full prescribing information for Opdivo.
View full prescribing information for Cabometyx.

The nivolumab review used the Real-Time Oncology Review (RTOR) pilot program, which streamlined data submission prior to the filing of the entire clinical application. Both the nivolumab and the cabozantinib applications used the Assessment Aid, a voluntary submission from the applicant to facilitate the FDA’s assessment. The FDA approved this application approximately one month ahead of the FDA goal date.

The nivolumab application was granted fast track review, and both the nivolumab and cabozantinib applications were granted priority review. A description of FDA expedited programs is in the Guidance for Industry: Expedited Programs for Serious Conditions-Drugs and Biologics.

Healthcare professionals should report all serious adverse events suspected to be associated with the use of any medicine and device to FDA’s MedWatch Reporting System or by calling 1-800-FDA-1088.

Sumanta Kumar Pal, MD of City of Hope , Duarte, CA shares the new research in renal cell carcinoma he is most excited about at the European Society for Molecular Oncology (ESMO) 2016 Congress in Copenhagen, Denmark. He discusses data he is presenting at this congress on quality of life in the context of cabozantinib treatment (NCT01865747). Dr Pal describes the step-wise increase in quality of life seen during the course of therapy with this second-line agent in renal cell carcinoma, and argues why he prefers cabozantinib over other treatment options.

Matthew Campbell, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, talks on an Phase II study (NCT03370718) exploring the role of cabozantinib, a tyrosine kinase inhibitor, in adrenocortical carcinoma (ACC) management. 18 patients were enrolled with advanced ACC, with the primary endpoint being progression-free survival (PFS) at 4 months (PFS4). The median follow-up was 19.4 months and the PFS4 was 72%, median PFS was 7.2 months. 16 patients had restaging with ORR including 2 partial response, 12 stable disease, and 2 progressive disease as best response; disease control rate was 78%. The median PFS was 7.2 months and median OS was 23.9 months. Overall, cabozantinib was shown to be able to provide sustained disease control in patients with advanced ACC and a manageable safety profile in the majority of patients. This interview took place at the European Society for Medical Oncology (ESMO) 2022 Congress in Paris, France.

Chung-Han Lee, MD, PhD, from Memorial Sloan Kettering Cancer Center, New York, NY, discusses the promising results of the Phase II (NCT03635892) trial of cabozantinib plus nivolumab for non-clear cell renal cell carcinoma (RCC). The trial showed a 48% objective response rate (ORR) and a median progression-free survival (PFS) of 13 months in patients with papillary, unclassified, or translocation associated RCC. Median overall survival (OS) was 28 months, and the therapy demonstrated favorable safety profiles. These updated findings suggest that cabozantinib plus nivolumab could be an effective and well-tolerated treatment option for patients with metastatic non-clear cell RCC with certain histologies. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved

Cabometyx is a targeted therapy that works by inhibiting the growth and spread of cancer cells. While it can be a life-saving treatment option, it is important to be aware of the potential side effects that may arise.
One of the most common side effects of Cabometyx is fatigue. Many patients experience a sense of tiredness and lack of energy, which can impact daily activities and overall quality of life. It is essential to communicate any fatigue to your healthcare team so that they can provide appropriate support and guidance.
Diarrhea is another common side effect of Cabometyx. The medication can disrupt the normal functioning of the digestive system, leading to loose or watery stools. It is important to stay hydrated and follow any dietary recommendations provided by your healthcare team to minimize the impact of diarrhea.
High blood pressure is a potential side effect that requires careful monitoring. Cabometyx can increase blood pressure levels, which can be especially problematic for individuals with pre-existing hypertension. Regular blood pressure checks and medication adjustments may be necessary to manage this side effect effectively.
Managing gastrointestinal side effects.
Coping with gastrointestinal side effects, such as diarrhea and nausea, can be challenging. However, there are strategies that can help minimize discomfort and improve overall well-being.
When it comes to diarrhea, maintaining good hydration is crucial. Drinking plenty of fluids, such as water and clear broths, can help replace lost fluids and electrolytes. Avoiding spicy and greasy foods, as well as caffeine and alcohol, can also be beneficial in reducing diarrhea episodes.
Nausea can be managed by eating small, frequent meals throughout the day rather than large meals. Avoiding strong smells and eating bland, easily digestible foods can also help alleviate symptoms. If nausea persists, anti-nausea medications prescribed by your healthcare team may be necessary.
Coping with fatigue and weakness.
Fatigue and weakness are common side effects of Cabometyx that can significantly impact daily functioning. However, there are strategies that can help manage these symptoms and improve overall energy levels.
Prioritizing rest and getting enough sleep is essential for combating fatigue. Listen to your body and allow yourself to rest when needed. Engaging in gentle exercises, such as walking or yoga, can also help boost energy levels and reduce fatigue.
Maintaining a well-balanced diet rich in nutrients is crucial for managing weakness. Incorporating lean proteins, fruits, vegetables, and whole grains into your meals can provide the necessary energy to combat weakness. Additionally, avoiding excessive caffeine and sugar consumption can prevent energy crashes.
Addressing hand-foot síndrome.
Hand-foot syndrome, also known as palmar-plantar erythrodysesthesia, is a potential side effect of Cabometyx that affects the palms of the hands and soles of the feet. It can cause redness, swelling, and pain, making it difficult to perform daily activities.

Dealing with hypertension and cardiovascular side effects.
High blood pressure is a potential side effect of Cabometyx that requires careful management. Regular blood pressure monitoring and medication adjustments may be necessary to keep blood pressure levels in check.
In addition to medication, lifestyle modifications can also play a crucial role in managing hypertension. Maintaining a healthy weight, engaging in regular physical activity, following a low-sodium diet, and reducing stress levels can all contribute to better blood pressure control.
It is important to communicate any symptoms or concerns related to cardiovascular side effects to your healthcare team promptly. They can provide guidance and make necessary adjustments to ensure your safety and well-being.
Managing dermatologic side effects.
Dermatologic side effects, such as skin rash and dryness, can occur with Cabometyx treatment. These side effects can be uncomfortable and impact self-esteem. However, there are strategies to help manage them effectively.


"DISCLAIMER: The content of this video is for informational and educational purposes only. It should not be used as a substitute for medical consultation. You should always seek the advice of your doctor or healthcare professional before taking any medication or starting any treatment. Treatments and medications should be prescribed and supervised by a qualified medical doctor only. Individual results may vary and the effectiveness of any treatment mentioned in this video is not guaranteed. Do not self-medicate, if you have any health problems, it is important to seek medical help immediately.



"

Dr Choueiri talks to ecancer at ESMO 2023 about the phase II LITESPARK-003 study, which
has so far indicated that the combination of belzutifan and cabozantinib is a promising treatment for advanced clear cell renal cell carcinoma.

The study found the treatment option to be effective in both first-line and subsequent-line settings and showed durable anti-tumour activity with a safety profile consistent with prior observations.

These results further support the use of an HIF-2α inhibitor and VEGFR-TKI combination for treating advanced ccRCC.

Xiao X. Wei, MD, MAS, instructor of medicine, Harvard Medical School, Dana-Farber Cancer Institute, discusses the side effect profile of cabozantinib (Cabometyx) in advanced kidney cancer.

Laurence Albiges, MD, PhD, from the Gustave Roussy Institute, Villejuif, France discusses the safety of cabozantinib treatment in metastatic renal cell carcinoma at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. Cabozantinib is a potent VEGFR tyrosine kinase inhibitor (TKI), and is used for second-line or later treatment in patients in whom prior VEGFR inhibitor treatment failed. Dr Albiges describes common side effects of cabozantinib treatment, which can include hypertension, hand-foot syndrome (acral erythema), diarrhea, and fatigue. Management of these will often require a dose reduction, with 2 out of 3 patients in the Phase III METEOR trial of cabozantinib needing a dose reduction (NCT01865747). However, she argues that the positive effect of cabozantinib on overall survival (OS) and progression-free survival (PFS) speak for its use as a second-line treatment in metastatic renal cell carcinoma.

Nicholas J. Vogelzang, MD, from the Comprehensive Cancer Centers of Nevada describes cabozantinib's side effects.

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Dr. Rupeena Purewal invites special guest Saskatoon pharmacist Carley Pozniak to review Cabenuva, an antiretroviral agent for HIV. Cabenuva (Cabotegravir Extended Release Injectable Suspension) has been approved in 2020 for medical use in Canada.

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Cabenuva is a long-acting injectable treatment for HIV-1, combining cabotegravir and rilpivirine. It is administered monthly or every two months and helps maintain viral suppression in people living with HIV.

Today I started Cabenuva, which is an injectable HIV treatment option. Every four weeks, I will go to the clinic to get the cabenuva injections. Although there is no cure for HIV, the ability to no longer have to take pills is hugely relieving.

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In this video I provide an update on my journey with Cabenuva ,which is a long-acting injectable for HIV treatment.

In this Video by Pharmacist Care I am going to talk about Bystolic ( generic name Nebivolol). Bystolic Side effects , uses and Mechanism of action.

Nebivolol is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.This medication belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural substances in your body, such as epinephrine, on the heart and blood vessels. This effect lowers heart rate, blood pressure, and strain on the heart.

Nebivolol, also known as Bystolic, is a medication used to treat high blood pressure. By lowering high blood pressure, it helps prevent strokes, heart attacks, and kidney problems. This medication belongs to a class of drugs called beta blockers, and it works by blocking the action of certain natural substances in the body, such as epinephrine, on the heart and blood vessels. This lowers heart rate, blood pressure, and strain on the heart. It is important to take Bystolic exactly as prescribed by your doctor, and the typical starting dose is 5 mg once daily. It can be taken with or without food, but it is important to take it at the same time each day. Always follow your doctor's instructions for the best results.
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