Tremelimumab is a targeted drug that fights tumors by regulating the immune system. Its indications focus on the treatment of specific types of cancer. Understanding the core uses of this drug can help patients and their families develop a reasonable treatment plan.
What diseases is Tremelimumab mainly used to treat?
The clinical application of Tremelimumab focuses on two malignant tumors, and the treatment effect is improved by combining other drugs. The following is an analysis of specific indications.
Unresectable hepatocellular carcinoma
Tremelimumab combined with Durvalumab is suitable for the treatment of unresectable hepatocellular carcinoma (uHCC) in adults. In the treatment plan, patients need to receive a combined infusion of 1300 mg of Tremelimumab and 1500 mg of Durvalumab in the first cycle, followed by single-drug maintenance treatment every 4 weeks. Patients weighing less than 30 kg need to adjust the dose to 4 mg/kg according to their weight, combined with 20 mg/kg of Durvalumab. Clinical trials have shown that this regimen can significantly prolong patient survival and delay disease progression.
Metastatic non-small cell lung cancer
For adult patients with metastatic non-small cell lung cancer (NSCLC) without EGFR mutations or ALK gene abnormalities, Tremelimumab needs to be used in combination with durvalumab and platinum chemotherapy. The specific dose is adjusted according to tumor histology and patient weight: when the weight of patients with non-squamous lesions is ≥30kg, Tremelimumab 75mg is combined with durvalumab 1500mg; when the weight is <30kg, the dose is 1mg/kg. Combination chemotherapy regimens can improve tumor control rate and reduce the risk of metastasis.
Tremelimumab activates T cells to attack tumors by blocking the CTLA-4 immune checkpoint. The selection of its indications must strictly follow the results of patient genetic testing and pathological typing.
How to use Tremelimumab
The dosing regimen of Tremelimumab is complex, and a precise plan must be formulated in combination with individual patient characteristics and combined drugs. The following are key usage specifications.
Dosage and dosing frequency
The recommended dose for patients with hepatocellular carcinoma is intravenous infusion once every 4 weeks, and then switched to single-drug maintenance after initial combination therapy. Patients with non-small cell lung cancer need to receive an infusion of Tremelimumab on the first day of each cycle, followed by durvalumab and platinum chemotherapy. For children or adults weighing less than 30 kg, the dose needs to be adjusted by 1 mg/kg to ensure a balance between drug concentration and efficacy.
Order of combined medication and infusion management
Tremelimumab should be infused before other drugs. For example, when combined with durvalumab, the latter infusion should be started 1 hour after the former infusion is completed; if combined with chemotherapy, it should be started within 30 minutes after the end of durvalumab. The infusion time must be strictly controlled to more than 60 minutes, and a 0.2μm filter should be used to avoid solution contamination. The patient should be observed for 60 minutes after the first infusion to monitor allergic or infusion reactions.
Drug dilution requires the use of 0.9% sodium chloride or 5% glucose solution, with a final concentration not exceeding 10 mg/mL. If not used immediately after preparation, it must be refrigerated at 2℃-8℃ for no more than 24 hours to avoid freezing or shaking.
Possible laboratory abnormalities with Tremelimumab
During Tremelimumab treatment, changes in multiple laboratory indicators may occur, which require regular monitoring to ensure the safety of treatment.
Increased liver function indicators
About 40% of patients experience elevated AST (aspartate aminotransferase) and ALT (alanine aminotransferase), and some cases are accompanied by abnormal bilirubin or alkaline phosphatase. If ALT/AST rises to more than 8 times the upper limit of normal, or total bilirubin exceeds 3 times the normal value, the drug must be permanently discontinued. Mild elevations (within 3 times) can be suspended and liver protection treatment can be given.
Abnormalities of the blood system
Decrease in hemoglobin and decrease in lymphocytes are common hematological reactions. Decreased hemoglobin levels may aggravate anemia symptoms, and regular testing and evaluation of transfusion requirements are required. Too low lymphocyte counts may increase the risk of infection, and it is recommended to strengthen immune support and infection prevention measures.
If adverse reactions such as rash, diarrhea, or muscle pain occur during treatment, you should communicate with your doctor in time to adjust the plan. The drug should be stored at 2°C-8°C away from light and should be avoided from repeated freezing and thawing after opening. Patients should strictly follow the doctor's instructions to complete regular checkups to ensure maximum treatment benefits.
The efficacy and risks of Tremelimumab coexist, and patients need to fully understand the treatment goals and potential side effects. Maintaining close communication with the medical team and timely feedback on physical changes will help optimize individualized treatment plans.
