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Ciltacabtagene autoleucel (Intravenous)

Medically reviewed by Drugs.com. Last updated on May 22, 2022.

Intravenous route(Suspension)

Warning: Cytokine release syndrome, neurological toxicities, HLH/MAS and prolonged and recurrent cytopenia Cytokine Release Syndrome (CRS), including fatal or life-threatening reactions, occurred in patients following treatment with ciltacabtagene autoleucel. Do not administer ciltacabtagene autoleucel to patients with active infection or inflammatory disorders. Treat severe or life-threatening CRS with tocilizumab or tocilizumab and corticosteroids.Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS), which may be fatal or life-threatening, occurred following treatment with ciltacabtagene autoleucel, including before CRS onset, concurrently with CRS, after CRS resolution, or in the absence of CRS. Monitor for neurologic events after treatment with ciltacabtagene autoleucel. Provide supportive care and/or corticosteroids as needed.Parkinsonism and Guillain-Barré syndrome and their associated complications resulting in fatal or life-threatening reactions have occurred following treatment with ciltacabtagene autoleuce.Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome (HLH/MAS), including fatal and life-threatening reactions, occurred in patients following treatment with ciltacabtagene autoleucel. HLH/MAS can occur with CRS or neurologic toxicities.Prolonged and/or recurrent cytopenias with bleeding and infection and requirement for stem cell transplantation for hematopoietic recovery occurred following treatment with ciltacabtagene autoleucel.Ciltacabtagene autoleucel is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the ciltacabtagene autoleucel REMS Program .

Commonly used brand name(s)

In the U.S.

  • Carvykti

Available Dosage Forms:

  • Suspension

Therapeutic Class: Antineoplastic Agent

Chemical Class: CAR T-Cell Agent

Uses for ciltacabtagene autoleucel

Ciltacabtagene autoleucel injection is used to treat multiple myeloma (bone marrow cancer) in patients whose cancer has come back and who have received at least 4 previous treatments (eg, an anti-CD38 monoclonal antibody, a proteasome inhibitor, and an immunomodulatory agent) that did not work well.

Ciltacabtagene autoleucel injection is an antineoplastic (cancer) medicine that is made from your own white blood cells, which have been modified to recognize and attack your cancer cells. Before you begin treatment, talk to your doctor about the benefits of ciltacabtagene autoleucel as well as the possible risks of receiving it.

Ciltacabtagene autoleucel is available only under a restricted distribution program called Carvykti™ REMS (Risk Evaluation and Mitigation Strategy) Program.

Before using ciltacabtagene autoleucel

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 ciltacabtagene autoleucel, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ciltacabtagene autoleucel 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.

Pediatric

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

Geriatric

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

Breastfeeding

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.

Interactions with 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.

Interactions with food/tobacco/alcohol

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 ciltacabtagene autoleucel. Make sure you tell your doctor if you have any other medical problems, especially:

  • Heart problems or
  • Heart rhythm problems (eg, tachycardia) or
  • Hypotension (low blood pressure) or
  • Infections (including hepatitis B), active or history of or
  • Lung or breathing problems or
  • Kidney disease or
  • Seizures, history of or
  • Stroke, history of—Use with caution. May cause side effects to become worse.

Proper use of ciltacabtagene autoleucel

A nurse or other trained health professional will give you ciltacabtagene autoleucel in a hospital or cancer center. It is given through a needle placed into one of your veins using a pump. Ciltacabtagene autoleucel must be given slowly, so your IV tube will need to stay in place for at least 30 to 60 minutes. It is given 2 to 4 days after completing treatment with other cancer medicines (eg, fludarabine, cyclophosphamide).

You may also receive other medicines (eg, allergy medicine, fever medicine) 30 to 60 minutes before starting treatment with ciltacabtagene autoleucel.

Your doctor will check you for unwanted effects at least daily for 10 days. Your doctor will also want you to stay close to the hospital or center for at least 4 weeks after your infusion.

It is very important that you understand the requirements of the Carvykti™ REMS program, and become familiar with the Carvykti™ Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

Precautions while using ciltacabtagene autoleucel

It is very important that your doctor check your progress at regular visits to make sure that ciltacabtagene autoleucel is working properly. Blood tests are needed to check for unwanted effects.

If you are a woman who can get pregnant, your doctor may do tests to make sure you are not pregnant before starting treatment.

Ciltacabtagene autoleucel may cause cytokine release syndrome (CRS), which may be life-threatening and requires immediate attention. Tell your doctor right away if you have fever, chills, headache, nausea, lightheadedness, dizziness, fainting, skin rash, trouble breathing, or tiredness or weakness.

Ciltacabtagene autoleucel may cause serious nerve problem, including parkinsonism, Guillain-Barré syndrome, peripheral neuropathy, and cranial nerve palsies. Check with your doctor right away if you have seizures, loss of balance, loss of consciousness, confusion, disorientation, difficulty with speaking, slurred speech, or sudden numbness and weakness in the arms and legs.

Ciltacabtagene autoleucel may cause a severe inflammatory condition that could be life-threatening, including hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS), which is caused by an overactive immune system. Check with your doctor right away if you have a fever, cough that does not go away, right upper abdominal or stomach pain and fullness, rash, redness in one part of your body, swollen, painful, or tender lymph glands in the neck, armpit, or groin, mental status changes, shakiness and unsteady walk, unsteadiness, trembling, or other problems with muscle control or coordination, seizures, or warm feeling or swelling of your skin.

Check with your doctor right away if you have a rash, itching, dizziness, fainting, fast heartbeat, trouble breathing or swallowing, or chest tightness while you are using ciltacabtagene autoleucel. These may be symptoms of serious allergic reactions, including anaphylaxis, which may be life-threatening and require immediate medical attention.

Ciltacabtagene autoleucel lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.

Ciltacabtagene autoleucel may increase your risks for hypogammaglobulinemia (immune system problem) and getting other cancers. Talk to your doctor if you have questions about these risks.

While you are being treated with ciltacabtagene autoleucel injection, do not have any immunizations (vaccinations) without your doctor's approval. Live virus vaccinations should not be given for at least 6 weeks before start of treatment, during treatment, and until recovery following the last cycle of ciltacabtagene autoleucel.

Ciltacabtagene autoleucel may cause dizziness, confusion, seizures, or decreased alertness. Do not drive or do anything else that could be dangerous until you know how ciltacabtagene autoleucel affects you, for at least 8 weeks after treatment.

Before you have any medical tests, tell the medical doctor in charge that you are taking ciltacabtagene autoleucel. The results of some tests may be affected by ciltacabtagene autoleucel.

Ciltacabtagene autoleucel side effects

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

  • Agitation
  • back pain
  • black, tarry stools
  • bladder pain
  • bleeding gums
  • blood in the eye
  • bloody or cloudy urine
  • blurred vision
  • body aches or pain
  • bone pain
  • bruising
  • chest pain or tightness
  • chills
  • confusion
  • confusion as to time, place, or person
  • cough or hoarseness
  • coughing up blood
  • decreased vision or other changes in vision
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • ear congestion
  • eye pain
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • fever
  • frequent urge to urinate
  • hallucinations
  • headache
  • holding false beliefs that cannot be changed by fact
  • increased menstrual flow or vaginal bleeding
  • irritability
  • large, flat, blue or purplish patches in the skin
  • lightheadedness
  • loss of voice
  • lower back or side pain
  • mood or mental changes
  • muscle pain, spams, twitching, or jerking
  • nervousness
  • nosebleeds
  • painful or difficult urination
  • pale skin
  • paralysis
  • pounding in the ears
  • prolonged bleeding from cuts
  • red or dark brown urine
  • redness in whites of the eyes
  • rhythmic movement of the muscles
  • seizures
  • sneezing
  • sore throat
  • stiffness
  • stuffy or runny nose
  • sweating
  • swelling
  • trembling and shaking of the hands
  • trouble breathing
  • trouble sleeping
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual excitement, nervousness, or restlessness
  • unusual tiredness or weakness
  • vomiting

Less common

  • Discouragement
  • feeling sad or empty
  • generalized slowing of mental and physical activity
  • incremental or ratchet-like movement of the muscle
  • lack of appetite
  • loss of balance control
  • loss of interest or pleasure
  • muscle discomfort
  • partial or slight paralysis
  • rigid or stiff muscles
  • seizures
  • shuffling walk
  • slowed movements
  • slurred speech
  • stiffness of the arms and legs
  • tic-like (jerky) movements of the head, face, mouth, and neck
  • trouble concentrating
  • trouble sleeping
  • uncontrolled eye movements

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

  • Constipation
  • diarrhea
  • rash

Less common

  • Abnormal posture
  • double vision
  • fall
  • seeing double

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.