Axicabtagene ciloleucel

Other Names: Yescarta™

Printable PDF Version

About This Drug

Axicabtagene ciloleucel is used to treat cancer. It is made using your own T-cells, a type of white blood cell. Your T-cells will be collected via leukopheresis, a procedure that circulates your blood through a machine and removes some of your T-cells. Your collected T-cells are then genetically modified and grown. Axicabtegene ciloleucel contains your modified T-cells and is given to you through the vein (IV).

Possible Side Effects

  • Abnormal heart beat
  • Increased heart rate
  • Nausea and throwing up (vomiting)
  • Constipation (unable to move bowels)
  • Diarrhea (loose bowel movements)
  • Tiredness
  • Fever
  • Fever when you have low white blood cells
  • Infection
  • Chills
  • Headache
  • Feeling dizzy
  • Tremors (shaking) 
  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), have trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
  • Decreased level of oxygen 
  • Cough
  • Low blood pressure
  • Cytokine release syndrome (CRS): Some types of cancer drugs can cause CRS because of the effects of the drug in your body. If this happens you may feel very sick and get a fever, headache, nausea, or feel weak. You may also have changes to your blood pressure. Because of this, your blood pressure and pulse will be checked while you are getting this drug. Tell your doctor or nurse right away if you have any of these symptoms while you are getting this drug: fever, chills, or shaking chills, feeling dizzy or lightheaded, have a headache and/or have nausea or throwing up.
  • Decreased appetite (decreased hunger)

Note: Each of the side effects above was reported in 20% or greater of patients treated with axicabtagene ciloleucel. Not all possible side effects are included above.

 Warnings and Precautions 

  • Cytokine release syndrome (CRS), which can very rarely be life-threatening
  • Severe changes in your central nervous system, which can very rarely be life-threatening.
  • Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction due to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment. 
  • Severe infections, including viral, bacterial and fungal, which can very rarely be life-threatening.
  • This drug may raise your risk of getting a second cancer.
  • Low blood cell counts, such as platelets, red and white blood cells, which could last for a long time. 
  • Decreased immunoglobulins in your body, which are antibodies and help you fight off infection. 

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

Important Information

  • This drug is only available through a restricted program (REMS). Your doctor will provide you more information about it. 
  • Because of the possible effect on your central nervous system, this drug may impair your ability to drive or use machinery. Do not drive or use machinery during your treatment and for 8 weeks after treatment.
  • Talk to your doctor before receiving any vaccinations during your treatment. Vaccinations are not recommended for 6 weeks prior to treatment, while receiving axicabtagene ciloleucel and after receiving axicabtagene ciloleucel - until your immune system is fully recovered.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time. 

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities
  • If you are dizzy, get up slowly after sitting or lying down. 
  • To decrease the risk of infection, wash your hands regularly. 
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease the risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Use an electric shaver instead of a razor.
  • Be very careful when using knives or tools.
  • To help with decreased appetite, eat small, frequent meals.
  • Eat foods high in calories and protein, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • Consider using sauces and spices to increase taste. Daily exercise, with your doctor’s approval, may increase your appetite.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help stop or lessen these symptoms.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your doctor or nurse about medicines that are available to help stop or lessen constipation and/ or diarrhea.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • Cytokine release syndrome may happen after your infusion. If this happens, call 911 for emergency care.

Food and Drug Interactions

  • There are no known interactions of axicabtagene ciloleucel with food and other medications.
  • Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions. 

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.4° F (38° C) or higher
  • Chills
  • Tiredness that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Confusion and/or agitation
  • Seizures
  • Hallucinations
  • Trouble understanding or speaking
  • Blurry vision or changes in your eyesight
  • Numbness or lack of strength to your arms, legs, face, or body
  • Headache that does not go away
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Coughing up yellow, green, or bloody mucus
  • Wheezing or trouble breathing
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • No bowel movement in 3 days or when you feel uncomfortable
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Signs of allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, call 911 for emergency care.
  • Signs of cytokine release syndrome such as: fever, chills, or shaking chills, feeling dizzy or lightheaded, have a headache and/or have nausea or throwing up
  • If you think you may be pregnant 

Reproduction Warnings

  • Pregnancy warning: This drug may have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment. Let your doctor know right away if you think you may be pregnant, or if you are planning to become pregnant after receiving axicabtagene ciloleucel. 
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking. 

Revised March 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.