elotuzumab

High Alert

Multiple myeloma in patients who have received 1–3 prior therapies (in combination with lenalidomide and dexamethasone).
Multiple myeloma in patients who have received ≥2 prior therapies including lenalidomide and a proteasome inhibitor (in combination with pomalidomide and dexamethasone).

Contraind./Precautions ⬆ ⬇

Contraindicated in:

OB: Pregnancy (since must be used with lenalidomide);
Lactation: Lactation.

Use Cautiously in:

Rep: Women of reproductive potential;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: bradycardia, hypertension, tachycardia

EENT: cataracts

F and E: hyperkalemia

GI: ↑alkaline phosphatase, constipation, diarrhea, vomiting, HEPATOTOXICITY

Hemat: leukopenia, lymphopenia, thrombocytopenia

Metab: ↓appetite, hypoalbuminemia, weight loss

MS: pain

Neuro: headache, peripheral neuropathy

Resp: cough

Misc: fatigue, fever, infection, infusion reactions, MALIGNANCY, night sweats

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Lyophilized powder for injection: 300 mg/vial; 400 mg/vial

Route/Dosage ⬆ ⬇

In Combination with Lenalidomide and Dexamethasone

IV (Adults ): 10 mg/kg once weekly (on Days 1, 8, 15, and 22) of Cycles 1 and 2 (each cycle = 28 days; total of 8 doses), then every 2 wk (on Days 1 and 15) of each 28-day cycle; continue until disease progression or unacceptable toxicity.

In Combination with Pomalidomide and Dexamethasone

IV (Adults ): 10 mg/kg once weekly (on Days 1, 8, 15, and 22) of Cycles 1 and 2 (each cycle = 28 days; total of 8 doses), then 20 mg/kg every 4 wk (on Day 1 of each 28-day cycle); continue until disease progression or unacceptable toxicity.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Targets the SLAMF7 protein on tumor cells and natural killer cells to facilitate killing of myeloma cells.

Therapeutic effects:

Improved survival and decreased progression of multiple myeloma.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: monoclonal antibodies

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	unknown	end of infusion	unknown

Patient/Family Teaching ⬆ ⬇

Inform patient of premedication regimen. Advise patient to read Patient Information prior to first infusion.
Instruct patient to notify health care professional if signs and symptoms of infusion reactions occur within 24 hr of infusion and if signs and symptoms of infection or liver problems (tiredness, weakness, loss of appetite, yellowing of skin or eyes, color changes in stools, confusion, swelling of stomach area) occur.
Inform patient of risk of developing secondary infections.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Rep: Advise patient that lenalidomide and pomalidomide may cause fetal harm and have REMS programs for combination of lenolidomide or pomalidomide with elotuzumab (REVLIMID REMS® and POMALYST REMS). Requirements regarding contraception, pregnancy testing, sperm donation, and transmission of sperm must be followed. Advise patient to notify health care professional if pregnancy is planned or suspected and avoid breastfeeding.

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Indications ⬇