Torisel Side Effects

Torisel (temsirolimus) treats advanced renal cell carcinoma by disrupting the pathway that signals cell growth, thus stopping or slowing tumor growth. Torisel acts specifically on cancer cells and leaves healthy cells unaffected. Rash, weakness and nausea are commonly associated with Torisel, but these side effects are fewer and less severe than those experienced with standard chemotherapy.

What is Torisel

• Torisel (temsirolimus) is a targeted therapy for advanced renal cell carcinoma (RCC). Torisel inhibits a specific enzyme called mammalian target of rapamycin (mTOR), which is a link in the chemical pathway that triggers cell growth. By inhibiting mTOR, Torisel prevents the tumor from growing larger. Torisel also disrupts the ability of the cancer cells to form their own blood supply, another characteristic of cancer that allows the tumor to spread.

Adverse Events

• The most common side effects associated with Torisel treatment include rash, weakness, mucositis (inflammation of the mucous membranes), nausea, swelling and anorexia. Torisel therapy may also cause elevated liver enzymes, anemia and metabolic abnormalities, such as increased levels of blood glucose, triglycerides, lipids and creatinine. For most patients receiving Torisel, the side effects were not severe enough to cause patients to discontinue or delay treatment.

Warnings and Precautions

• Patients taking Torisel may experience hypersensitivity reactions, causing chest pain, an allergic reaction, flushing or shortness of breath. Hypersensitivity reactions typically occur during the first infusion of Torisel, but may also occur during subsequent doses. Antihistamines may be administered before treatment to prevent hypersensitivity. Because Torisel may increase blood glucose levels, serum glucose should be tested before each dose. Insulin may be necessary. Torisel may suppress the immune system and increase the risk of cerebral hemorrhage, especially in patients with central nervous system disorders. Patients have reported bowel perforation while taking Torisel. Progressive kidney failure unrelated to the cancer may also occur. Patients should avoid receiving live vaccines, such as those for measles, mumps, rubella, varicella and the oral polio and intranasal flu vaccines.

Drug Interactions

• Use of sunitinib while taking Torisel may result in rash, gout or cellulitis that is severe enough to limit subsequent Torisel doses. Torisel is metabolized by the enzyme cytochrome P3A4 (CYP3A4). During Torisel treatment, patients should avoid drugs that induce CYP3A4, such as dexamethasone, phenytoin, carbamazepine or phenobarbital. These medications decrease blood concentrations of Torisel and the dose may need to be increased. Similarly, patients should also avoid drugs that inhibit CYP3A4 because these drugs will decrease concentrations of Torisel, necessitating reduced doses. Examples of CYP3A4 inhibitors are ketoconazole, saquinavir, clarithromycin or nefazodone.

Special Considerations

• Women of childbearing age should avoid becoming pregnant while taking Torisel and for three months after the last dose. Patients with impaired kidney function can receive the full dose of Torisel. Torisel use in elderly patients or those with liver impairment has not been studied.