Pronunciation:

tor-ip-A-li-mab - tpzi

Brand Names:

• Loqtorzi

Dosage Forms:

• Solution

Classifications:

Therapeutic—

Antineoplastic Agent

Pharmacologic—

Toripalimab

Uses of This Medicine:

Toripalimab-tpzi injection is used in combination with cisplatin and gemcitabine as first-line treatment of nasopharyngeal carcinoma (nose and throat cancer) that has spread throughout the body (metastatic) or has returned. It is also used alone to treat nasopharyngeal carcinoma in patients who have received other cancer medicines (eg, platinum) that did not work well, or whose cancer has returned, cannot be removed by surgery, or has spread.

Toripalimab-tpzi is a monoclonal antibody that changes the immune system to help control the growth of cancer cells.

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of toripalimab-tpzi injection in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of toripalimab-tpzi injection in the elderly.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Colitis (inflammation of the bowels) or
• Diabetic ketoacidosis or
• Hepatitis (inflammation of the liver) or
• Hyperthyroidism (high levels of thyroid hormone) or
• Hypophysitis (inflammation of the pituitary gland) or
• Hypothyroidism (low levels of thyroid hormone) or
• Immune system problems (eg, Crohn's disease, ulcerative colitis, or lupus) or
• Muscle or nerve problems (eg, myasthenia gravis, Guillain-Barré syndrome) or
• Nephritis (inflammation of the kidneys) or
• Pneumonitis (inflammation of the lungs) or
• Type 1 diabetes—Use with caution. May make these conditions worse.

• Organ transplant (eg, kidney or liver transplant), recent—Use with caution. May increase risk for organ transplant rejection.

• Patients who have had allogeneic hematopoietic stem cell transplant (HSCT)—Use with caution. May cause side effects to become worse.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine. It is given through a needle placed into one of your veins. It must be given slowly, so the IV will have to remain in place for at least 30 or 60 minutes.

This medicine comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

Missed dose—

This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Receiving this medicine while you are pregnant can harm your unborn baby. If you are a woman who can get pregnant, your doctor may give you a pregnancy test before you start using this medicine to make sure you are not pregnant. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine and for 4 months after the last dose. If you think you have become pregnant while receiving the medicine, tell your doctor right away.

Tell your doctor right away if you have a cough, chest tightness, or any type of breathing problem with this medicine. These could be symptoms of a serious lung problem.

Colitis (swelling of the colon or bowel) may occur with this medicine. Tell your doctor right away if you have stomach pain or tenderness, watery or bloody diarrhea, or a fever after receiving the medicine.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Serious problems with the adrenal, pituitary, or thyroid glands (hormone glands) may occur while you are receiving this medicine. Tell your doctor if you start having continuing or unusual headaches, changes in mood or behavior (eg, being irritable or forgetful), lightheadedness, dizziness, or fainting, unusual sluggishness, or an increase in weight.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

This medicine may cause serious kidney problems (eg, nephritis, kidney failure). Tell your doctor right away if you have bloody or cloudy urine, nausea, vomiting, trouble breathing, swelling of the face, feet, or lower legs, unusual tiredness or weakness, or unusual weight gain.

Serious skin reactions (eg, exfoliative dermatitis, Stevens-Johnson syndrome, drug rash with eosinophilia and systemic symptoms (DRESS), and toxic epidermal necrolysis) can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, often with a purple center, severe acne or skin rash, sores or ulcers on the skin, mouth or lips, or swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness with this medicine.

Tell your doctor right away if you have changes in your eyesight, severe or persistent muscle or joint pain, or severe muscle weakness after receiving this medicine.

This medicine may cause infusion-related reactions. These can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving this medicine.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Arm or leg pain

back pain

blistering, peeling, or loosening of the skin

blurred vision

body aches or pain

bone pain

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

chest pain or tightness

chills

constipation

cough

cough producing mucus

cracks in the skin

depressed mood

diarrhea

difficulty moving

dizziness

dry skin and hair

ear congestion

enlarged pupils

feeling cold

fever

hair loss

headache

hoarseness or husky voice

increased sensitivity of the eyes to light

increased sweating, possibly with fever or cold, clammy skin

joint pain

loss of voice

muscle aches, cramps, pain, and stiffness

neck pain

nerve pain

nervousness

pain or tenderness around the eyes and cheekbones

pounding in the ears

red, swollen skin

red irritated eyes

red skin lesions, often with a purple center

slow or fast heartbeat

sneezing

sore throat

sores, ulcers, or white spots in the mouth or on the lips

stiff or sore neck

stuffy or runny nose

sweating

swollen joints

tender, swollen glands in neck

trouble breathing

trouble swallowing

trouble sleeping

unsteadiness or awkwardness

unusual tiredness or weakness

weakness in arms, hands, legs, or feet

weight gain or loss

Less common

General feeling of discomfort or illness

thickening of bronchial secretions

Rare

Anxiety

black, tarry stools

bleeding gums

bloating

blue or pale skin

burning feeling in the chest or stomach

change in vision

chest discomfort

confusion

dark urine

darkening of the skin

double vision

drooping eyelids

drowsiness

dry mouth

eye pain

fainting

flushed, dry skin

fruit-like breath odor

general feeling of illness

heavier menstrual periods

inability to move the arms and legs

increased hunger

increased thirst

increased urination

indigestion

irritability

loss of appetite

loss of consciousness

muscle aches or weakness

nausea or vomiting

nosebleeds

numbness or tingling in the fingers, face, or feet

pains in the stomach, side, or abdomen, possibly radiating to the back

pale skin

pinpoint red spots on the skin

seeing flashes or sparks of light

seeing floating spots before the eyes, or a veil or curtain appearing across part of vision

seizures

stomach pain, upset, or cramps

sudden numbness and weakness in the arms and legs

swollen, painful, or tender lymph glands in the neck, armpit, or groin

tearing

tenderness

unusual bleeding or bruising

watery or bloody diarrhea

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Swelling or inflammation of the mouth

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.