What is Dinutuximab?
Dinutuximab, in combination with other medications, is used to treat neuroblastoma in children (a rare form of cancer that affects the nervous system). Dinutuximab can be given to a child after other treatments have been tried. Dinutuximab can be used in other ways not mentioned in this guide.
Side effects of Dinutuximab
Should your child present any of the signs or symptoms associated with an allergic reaction, seek medical assistance immediately. Some side effects can occur immediately after the injection or even up to 24 hours later. If your child is dizzy, light-headed, or has a rash on the skin, chest tightness, wheezing, or difficulty breathing, tell the caregiver. Capillary Leak Syndrome is an unusual and potentially serious side effect.If your child shows signs of this condition, call your doctor immediately: a runny or stuffy nose, followed by fatigue, thirst, decreased urine, difficulty breathing, sudden swelling, or weight gain. Dinutuximab may damage red blood cells, which can lead to irreversible renal failure. If your child experiences unusual bleeding or bruising, confusion, fatigue or irritability, stomach pains, bloody diarrhea, red or pink urine, or swelling, call your doctor immediately.If you suspect something, contact your physician immediately:
- Sudden vision loss or vision changes;
- Headache, confusion, thinking difficulties, seizures
- Severe dizziness and fainting
- Vomiting, diarrhea, feeling very ill;
- Nerve problems: sharp or shooting pains, numbness, tingling or burning, cold or burning sensations, weakness, difficulty walking or doing daily activities, loss in bladder or bowel controls;
- Low blood cell counts may also bring fever, chills and tiredness as symptoms. They may also include mouth sores or skin sores.
- Signs of electrolyte depletion include increased thirst, urination, or muscle cramps.
Dinutuximab side effects may include:
- Capillary leak syndrome
- A reaction to an infusion
- Feeling light-headed
- Pain;
- Low blood cell count
- An electrolyte imbalance;
- Vomiting, diarrhea;
- Rash;
- Abnormal liver function tests
There may be other side effects. For medical advice on side effects, call your doctor. Reaching the Food and Drug Administration to report adverse events is as easy as dialing 1-800-FDA-1088.
Similar/related drugs
Cisplatin, doxorubicin, vincristine, Adriamycin, Unituxin, and Platinol
Warnings
If your child is experiencing severe pain or worsening, numbness, tingling, or weakness, or has difficulty walking or performing daily activities, call your doctor immediately.
During the injection, some side effects can occur, such as dizziness, skin irritation, chest tightness, or wheezing.
Before you take this drug
Dinutuximab should not be given to your child if you have an allergy.
If your child has experienced any of the following:
- Any type of bacterial or viral infection
- An eye disorder or a vision problem;
- Bone marrow suppression
- Low blood pressure
- An electrolyte imbalance is a low blood potassium, sodium, or calcium level.
- Liver or kidney disease
- Urination problems.
How to take Dinutuximab?
Dinutuximab can be injected directly into a vein. Dinutuximab can be injected over ten to twenty hours.Dinutuximab will be given over a 28-day treatment cycle. This injection will only be given on certain days during the cycle.Your doctor will determine how many cycles your child needs.You may need to give your child other medications to prevent certain side effects.You will monitor your child for at least four hours to ensure that he or she doesn't have an adverse reaction to the medication.You may have to take your child for frequent medical exams, and the treatment could be delayed depending on the results.
Details on dosage
The usual pediatric dose for neuroblastoma is:
17.5 mg/m2/day intravenously over 10–20 hours, 4 days in a row. Maximum: 5 cycles.
Infuse at days 4, 5, 6, and 7 of cycles 1, 3, and 5. (Cycles 1, 3, and 5 have a 24-day duration.)
Infuse on days 8, 9, 10, and 11 of cycles 2 and 4. (Cycles 2 and 4, 32-day duration)
Rate of Infusion
Start at 0.875 mg/m2/hour and continue for 30 minutes. Increase the rate as tolerated, up to a maximum of 1.75 mg/m2/hour.
Comments:
Pre-treatment and guidelines for pain management IV hydration:
1) Hydration:
-Administer 10 mL/kg of 0.9% sodium sulfate IV for an hour prior to starting each infusion.
2) Analgesics:
-Administer morphine 50 mcg/kg intravenously immediately before infusion. Then continue as a drip of morphine at a rate of 20–50 mcg/kg/hour for the duration of two hours after the completion of treatment.
Add 25 to 50 mg/kg of morphine to the IV as needed to relieve pain, up to twice every two hours. Increase the rate of morphine infusion in stable patients.
If morphine is not tolerated, consider using fentanyl hydromorphone.
If opioids are not enough to manage pain, consider using lidocaine or gabapentin with IV morphine.
3) Antihistamines and antipyretics:
-Administer an antihistamine, such as Diphenhydramine (0.5–0.1 mg/kg, maximum dose 50 mg), IV every 4-6 hours or as tolerated, starting 20 minutes before the start of treatment.
Acetaminophen (up to 15 mg/kg, maximum dose of 650mg) should be administered 20 minutes before each infusion. Repeat every 4 to 6 hours as needed to control a fever or pain. Ibuprofen (5–10 mg/kg) is administered every 6 hours to control persistent pain or fever.
Use: When combined with granulocyte-macrophage colony stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), this treatment should be prescribed for pediatric patients diagnosed with high-risk neuroblastomas who achieved at least partial responses after receiving previous multiagent, multimodality treatment regimens.
What happens if I miss the dose?
It is unlikely that your child will miss a dosage in a medical setting.
What happens if I overdose?
In a medical setting, an overdose is treated immediately.
What should be avoided?
If your doctor prescribes any restrictions regarding food, beverage, or activity, follow their instructions.
Interaction with other drug
Dinutuximab can be affected by other drugs, such as prescription and over-the-counter medicines, vitamins, and herbal supplements. Inform your doctor of all the other medications you take.
