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Loqtorzi (toripalimab-tpzi)
toripalimab
Adult Dosing .
Dosage forms: INJ
Special Note
- [drug name clarification]
- Info: nonproprietary name = toripalimab-tpzi
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
nasopharyngeal CA
- [first-line tx, combo tx]
- Dose: 240 mg IV q3wk for up to 24mo; Info: for pts w/ metastatic or recurrent locally advanced dz
- [previously treated dz, monotherapy]
- Dose: 3 mg/kg/dose IV q2wk; Info: for pts w/ metastatic or recurrent unresectable dz w/ progression on or after platinum-containing chemo
renal dosing
- [see below]
- CrCl >60: no adjustment; CrCl <60: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin 1.1-1.5x ULN or AST >ULN: no adjustment; bilirubin >1.5x ULN: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- avoid: breastfeeding during tx and x4mo after D/C
- caution: pts of childbearing potential
- caution: thoracic XRT hx
- caution: transplant hx
- caution: transplant candidates
Drug Interactions .
Overview
toripalimab
PD-1 blocking antibody
- immunomodulatory effects (other)
Contraindicated
- adenovirus vaccine, live
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- rabies vaccine
Monitor/Modify Tx
- anthrax vaccine
- chikungunya vaccine
- COVID-19 vaccine
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- ebola vaccine, live
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- influenza H5N1 vaccine
- influenza vaccine
- Japanese encephalitis vaccine
- meningococcal vaccine
- pneumococcal vaccine
- poliovirus vaccine
- respiratory syncytial virus vaccine
- smallpox/mpox vaccine, live
- tick-borne encephalitis vaccine
- typhoid vaccine
Adverse Reactions .
Serious Reactions
- immune-mediated rxn
- pneumonitis
- colitis
- hepatotoxicity
- hepatitis
- endocrinopathy
- adrenal insufficiency
- hypophysitis
- hypothyroidism
- hyperthyroidism
- thyroiditis
- diabetes mellitus, type 1
- hypopituitarism
- nephritis
- Stevens-Johnson syndrome
- drug rxn w/ eosinophilia and systemic sx
- toxic epidermal necrolysis
- myocarditis
- pericarditis
- vasculitis
- meningitis
- encephalitis
- demyelination
- nerve paresis
- myasthenia gravis
- Guillain-Barre syndrome
- neuropathy
- uveitis
- Vogt-Koyanagi-Harada-like syndrome
- pancreatitis
- myositis
- rhabdomyolysis
- hypoparathyroidism
- hemolytic anemia
- aplastic anemia
- hemophagocytic lymphohistiocytosis
- immune thrombocytopenic purpura
- infusion rxn, severe
- hypersensitivity rxn
- anaphylaxis
- thrombocytopenia
- anemia
- pneumonia
Common Reactions
- hypothyroidism
- fatigue
- cough
- musculoskeletal pain
- fever
- appetite decr.
- constipation
- pruritus
- rash
- weight loss
- hyperthyroidism
- hepatitis
- pneumonitis
- infusion rxn
- lymphocytes decr.
- Hgb decr.
- albumin decr.
- sodium decr.
- phosphate decr.
- ALT or AST incr.
- calcium decr.
- alk phos incr.
- triglycerides incr.
- glucose incr.
Safety/Monitoring .
Monitoring Parameters
pregnancy test at baseline; Cr, LFTs, TFTs at baseline, then periodically; glucose; s/sx infusion rxn
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; risk of embryo-fetal toxicity, incl. spontaneous abortion and stillbirth, based on animal data w/ other PD-1/PD-L1 pathway inhibitors and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x4mo after D/C in pts of childbearing potential
Lactation
Clinical Summary
avoid breastfeeding during tx and x4mo after D/C; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: catabolism; CYP450: unknown
Excretion: other; Half-life: 18 days
Subclass: Immunotherapy, Immune Checkpoint Inhibitors ; Immunotherapy, PD-1/PD-L1 Inhibitors
Mechanism of Action
binds to PD-1 receptor on T-cells, blocking PD-1 pathway-mediated inhibition of anti-tumor immune response, resulting in decreased tumor growth (monoclonal antibody)
Formulary .
No Formulary Selected
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