Yervoy is a type of cancer treatment called immunotherapy. Immunotherapy works by using the body's own immune system to fight cancer cells. Yervoy is designed to help the immune system fight a type of lung cancer called non-small-cell lung cancer (NSCLC). Yervoy was approved to be given in combination with another immunotherapy called Opdivo to treat NSCLC.
How Does Yervoy Work for Lung Cancer?
Some cancer cells have what are called checkpoint proteins on their cell surface. The immune cells in our body also have proteins on their surface. When these proteins bind to each other, the T cells in our body get "switched off,” which stops them from killing cancer cells. Yervoy acts on proteins on the T cell called CTLA-4 and prevents these proteins from binding to CTLA-4 proteins on the tumor cell. This turns the T-cell back “on” and allows it to do its job of attacking and killing the tumor cell.
What Kinds of Lung Cancer Does Yervoy Treat?
- NSCLC that is advanced or has spread to other parts of your body (metastatic) and is positive for the PDL-1 protein
- NSCLC that is metastatic or has come back (recurrent)
How Will I Get Yervoy?
Yervoy is put into a vein as an intravenous (IV) infusion. It will be given to you by a health care provider in a health care setting. The dose of Yervoy is 1 mg/kg given every 3 weeks. Your health care provider may stop Yervoy if your cancer gets worse (progresses) or you have side effects that prevent you from tolerating the medicine.
How Well Does Yervoy Work for Lung Cancer?
The FDA approved Yervoy for NSCLC based on several clinical trials.
Yervoy was studied in people with metastatic or recurrent NSCLC and a positive PDL-1 protein. In this trial, people received either Yervoy plus another immunotherapy called Opdivo, Opdivo alone, or chemotherapy. People were included if they had not received any other treatment for their advanced or metastatic NSCLC. This study looked at overall survival (OS) between the Yervoy plus Opdivo and chemotherapy groups. Overall survival measures how long people in the study survived after receiving their treatment. There were 1,189 people in this study, and they were evenly split up between the three treatment groups. The median age for the study was 64, and there were more men than women (65%). OS was 17.1 months in people getting Opdivo plus Yervoy and 14.9 months in people who got chemotherapy. This means the rate of overall survival was higher among the patients who received Yervoy plus Opdivo than for those who received chemotherapy.
Yervoy was also studied in people with metastatic or recurrent NSCLC that was either positive or negative for PDL-1. In this study, people received Yervoy plus Opdivo in combination with chemotherapy or chemotherapy alone. This study looked at OS. There were 719 patients in the study, and they were evenly split between the two treatment groups. The median age was 65, with 51% of patients 65 or older and 10% of patients 75 or older. Most patients were men (70%). People getting Yervoy plus Opdivo and chemotherapy had a median survival of 14.1 months, and people getting chemotherapy alone had a median overall survival of 10.7 months. This means people in the Yervoy group lived significantly longer than those in the chemotherapy group.
What Are Other Unique Considerations to Be Aware Of?
Yervoy can cause harm to a fetus. Your health care provider will discuss options for contraception while you take Yervoy. You should use an effective method of birth control while you are receiving Yervoy and for 3 months after your last dose. If you and your partner are or are planning to become pregnant, talk with your health care provider about your options. Yervoy may pass into your breastmilk if you are breastfeeding. You should not breastfeed while you are getting Yervoy and for 3 months after your last dose.
Yervoy can cause very serious side effects. These include lung problems, intestinal problems, liver problems, hormone gland problems, kidney problems, eye problems and skin problems. Problems can also happen in other organs and tissues. It is important to tell your health care provider as soon as you experience any side effects including chest pain, fast heartbeat, shortness of breath, confusion, double or blurry vision, severe muscle pains, or bruising more easily than usual.
What Are the Side Effects of Yervoy, and How Can I Prevent or Manage Them?
Yervoy can cause severe side effects including skin reactions, diarrhea, and high blood sugar levels.
Contact your health care provider right away if you notice any new rash or existing rash that is getting worse; reddening of the skin; fever; blistering of the lips, eyes, or mouth; blisters on the skin; skin peeling; or dry skin. They will decide whether you should continue or stop taking Yervoy. They will also recommend creams or antihistamines to help with your rash and itchiness. Skin reactions are the most common side effect of Yervoy and can occur at any time after you start taking it and even after you stop. You may also be given a corticosteroid to treat your rash.
Notify your health care provider as soon as diarrhea starts and start your diarrhea medicines. Drink more fluids to avoid losing too much of your body water (dehydration). Mild to moderate diarrhea can happen any time after you start taking Yervoy. Your health care provider may treat you with corticosteroids if your diarrhea is mild or moderate. If you have severe diarrhea, you may receive another immunosuppressive treatment given to you as an intravenous infusion.
Your health care provider will tell you if you need to monitor your fasting blood sugar levels (blood sugar after an overnight fast) while you are taking Yervoy. Contact your health care provider if you notice your blood sugar rising or start having symptoms like feeling more thirsty than usual, needing to pee more often or in greater amounts, or have blurred vision or headaches. Your health care provider will have you get lab tests regularly and decide how to best manage your blood sugar levels.
If you’re receiving Yervoy alongside platinum-based chemotherapy, your health care provider will typically recommend taking certain medications before your infusion to help prevent common side effects like nausea and vomiting, which are usually caused by the chemotherapy. It’s important to follow their instructions carefully. In addition to taking prescribed medications, you can ask your health care provider for additional strategies to manage or prevent side effects. For example, eating bland foods and having several small meals throughout the day, avoiding greasy foods, and drinking only small amounts of clear liquids can help manage nausea and vomiting.
If you have certain side effects while you take Yervoy, your health care provider may need to change how often you get infusions, pause your infusions, or even stop your medicine altogether. This will depend on how severe the side effect is that you have and what type of treatment it requires.
These are not all the possible side effects of Yervoy. Contact your health care provider for medical advice about side effects if you are having symptoms that bother you. You can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
How Do I Know if Yervoy Is Working?
Your health care provider will regularly check how well Yervoy is working for your cancer with tests such as blood tests and CT scans or MRI scans. You may notice improvements within a few weeks to months after starting Yervoy. The complete therapeutic effect can take longer, depending on individual factors and disease progression.
How Long Does Yervoy Stay in My System?
Yervoy remains in the body for several months after the last dose. Even after stopping Yervoy, immune-related side effects may continue. Regular follow-up is essential to manage any lingering side effects and ensure a smooth transition off the treatment.
