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Talimogene laherparepvec

Generic name: Talimogene laherparepvec [tal-IM-oh-jeen-la-HER-pa-REP-vek]
Name of the brand: Imlygic
Dosage form: Injectable suspension (1 mpfu/mL; 100 mpfu/mL)
The class of drug: Miscellaneous antineoplastics

What is Talimogene Laherparepvec?

Talimogene laherparepvec is a cancer medicine that alters the immune system of the body by assisting the body to produce the anti-tumour response. Talimogene laherparepvec is genetically modified to be a weak version of the type I herpes simplex virus (the virus that is responsible for the common cold sores). Talimogene laherparepvec can be used to treat a kind of cancer known as melanoma when it's located on the skin or within lymph glands. Talimogene laherparepvec can also be used to treat conditions that are not mentioned in this guideline.

Side effects of Talimogene laherparepvec

See a doctor immediately. If you are experiencing symptoms that indicate an allergic reaction, such as symptoms of hives, difficulty breathing, or swelling of your lips, face, and throat,

Contact your physician immediately if you show any indications that you might be at risk of contracting herpes simplex, for example:

  • The sensation of burning, tingling, or burning (especially on your lips or your genitals);
  • Muscle cramps or weakness in the leg or arm, sometimes with burning pain.
  • Eye discomfort, drainage, or crusting; eye pain, drainage, or crusting (your eyes might become more sensitive);
  • Insomnia, extreme sleepiness,
  • The blisters form on your fingers and ears, around your mouth, or on your genitals.

Contact your doctor if you suffer from:

  • Any skin lesions that do not heal, or
  • Redness, swelling, heat bleeding, and skin changes occurred after the injection was made.

Common adverse effects of talimogene, also known as laherparepvec, could be:

  • Fever, chills,
  • Flu-like symptoms;
  • Being tired;
  • Nausea; or
  • Discomfort where the medication was injected.

This is not a comprehensive list of all the side effects. Other side effects could occur. Consult your physician for advice regarding medical effects. You can report any symptoms to the FDA at 1-800-FDA-1088.

Warnings

Follow the directions on your prescription label and on the label of your package. Inform your healthcare professionals about your medical issues, allergies, and any medications you take.

Before taking this drug

A chance encounter with this virus contained in Talimogene's laherparepvec could result in the development of symptoms of herpesvirus infection. But not treating melanoma may allow it to spread and grow to other areas within the human body. Melanoma can be difficult to treat once it has advanced, and this kind of cancer could be fatal. Discuss with your physician the dangers and benefits of using talimogene in conjunction with laherparepvec.

It is not recommended to treat talimogene if you suffer from an allergic reaction to the drug or if

  • You have an immune system that is weak (caused by illness or taking certain medicines).
  • You are pregnant.

Inform your doctor if you were ever diagnosed with:

  • Cold sores or genital herpes
  • Blood cancer (leukaemia);
  • Bone marrow cancer (myeloma);
  • HIV or AIDS; or
  • An autoimmune disorder like rheumatoid arthritis, lupus, or psoriasis, an autoimmune disorder.

Inform your doctor if someone in your household is pregnant or is suffering from a weak immune system. Utilise efficient contraception to stop pregnancy and notify your doctor if you're pregnant. If you experience symptoms of herpes virus infection after taking talimogene, the laherparepvec virus may be transmitted to your child during the birth. It is not recommended to breastfeed while taking the drug talimogene, also known as laherparepvec. Talk to your doctor about any risks.

What is the Talimogene laherparepvec?

Talimogene laherparepvec is injected into the tumour of the skin or into the lymph node beneath your skin. Your doctor will provide you with the injection. This medication is usually administered every 2 weeks, or until the tumour has gone. The initial two doses of talimogene, also known as laherparepvec, are typically given three weeks apart. Your healthcare providers will employ specific precautions to prevent getting this medication into other parts of your body. If the medicine happens to get onto your skin, you should wash thoroughly with soap and warm water. The talimogene virus that is contained in laherparepvec is a weak variant of the herpes simplex virus that could spread to other areas of your body. Be sure to follow the instructions of your physician on how to take care of the areas of your body where this medication is injected.

  • For a minimum of one week following the injection, you should keep the area covered with an airtight, waterproof bandage. It is possible to keep the area covered for more than one week if the area is oozing or draining.
  • Make sure you change your dressing regularly to keep your skin neat.
  • Wear gloves made of latex while you clean the area of treatment or apply an additional bandage. Place the bandages and gloves you've used in a sealed plastic bag and dispose of them in the garbage.

The virus that is contained in this medication may also infect other people you are in frequent contact with. Avoid contact with those who are ill or suffer from infections. Do not kiss anyone who has mouth sores, an infection, or a cold sore (sometimes known as an infection blister). Avoid being around pregnant women.

Contact your physician if you notice any signs that lymph glands are tumours, even after the discontinuation of talimogene, also known as laherparepvec.

Details on dosage

Usual Adult Dose for Melanoma—Metastatic:

Initial Dose:
Up to 4 mL with a concentration of 10 (6) (1 million) plaque-forming units (PFU) per mL via intralesional injection.
The largest lesion(s) must be the first to be injected.
The remaining lesion(s) should be considered prioritised for injection based upon lesion size.

Second Dose:
up to 4 mL with an amount of 10 (8) (100 million) PFU per mL through intralesional injections 3 weeks following the first treatment.
New lesions that have developed since the initial treatment should be treated first.
The remaining lesion(s) must be deemed prioritised to be injected based on the lesion's size.

All subsequent treatments (including reinitiation):
up to 4 mL with an amount of 10 (8) (100 million) PFU/mL through intralesional injection 2 weeks following previous treatment.
Lesions that are new and have arisen after previous treatments should be treated prior to injection.
The remaining lesion(s) should be considered prioritised to be injected based on the lesion's size.

Maximum Dose: The maximum dose for each treatment visit must not exceed 4 mL for all the injected lesions.

Duration of Therapy:
At every visit for treatment Lesions must be injected until the maximum volume is reached or until the injectable lesion(s) are treated.
Complete treatment plan: at least 6 months unless another treatment is required or there are no lesions that can be injected to treat.

Comments:
The amount of the injection should be determined by lesion size (lesions that are clustered together must be considered a single lesion).
Greater than 5 cm up to 4 mL
More than 2.5 centimetres to five centimetres: up to 2 mL
Greater than 1.5 centimetres from 2.5 cm: up to 1 mL
Greater than 0.5 centimetres to 1.5 cm: up to 0.5 millilitres
-0.5 millimetres and less, up to 0.1 millilitres

Treatment: localization of non-resectable subcutaneous, cutaneous, and nodal lesions in patients who have melanoma that has recurred following the initial operation.

What happens If I miss a dose?

Contact your doctor for advice in the event that you don't make an appointment for an injection.

What happens if I overdose?

Since talimogene is administered by a health specialist in a medical setting, it is highly unlikely for an overdose to occur.

What should be avoided?

Be careful not to scratch or touch the area that the medicine is injecting.

The talimogene-containing virus laherparepvec is able to enter bodily fluids (urine and faeces, as well as semen and vomit). Be careful not to allow your body fluids to come into contact with the hands of others or other surfaces that are not cleaned. Always use a condom made of latex when you are having sexual contact. Carers should wear rubber gloves when cleaning a patient's body fluids, handling dirty trash or laundry, or changing diapers. Clean hands prior to and after taking off gloves. Cleanse linens and clothing that have been soiled separately from the rest of the laundry.

Follow your doctor's advice on the length of time you'll need to keep following these guidelines after the course of treatment is over.

Interaction with other drugs

Discuss with your doctor any other medications you take, including:

  • edications to treat herpes (acyclovir, valacyclovir, or others) as well as
  • Medications that can weaken your body's immune system (such as cancer drugs and steroids, as well as medications to prevent organ donation rejection).

This list isn't complete. Other medications may interact with talimogene, laherparepvec, and over-the-counter medicines, vitamins, and herbal products in a variety of ways. The interactions of all drugs are included here.