I just started Vyloy, I have 3 esophagus cancer , anyone else on this

I had my first and only treatment with Vyloy 7 days ago. 1 hour after they started the treatment my BP jumped, I felt extremely hot, my face was flushed, I felt like I needed to throw up and I was extremely restless. I have been battling stage 4 esphogeal cancer for over 4 years now and that was the single worst I have felt. I had to return to the treatment center 3 times for hydration and more anti nausea medicine. Throughout the past 7 days I have had “episodes” when my face is flushed and hot, I have body chills and hyper saliva production. I do not run a temperature although it feels like it. I have found that ibuprofen seems to help with the episodes. My oncologist and I have decided to discontinue the Vyloy treatment and continue with chemotherapy. Good luck to you and I pray you have successful treatments with less side effects.

Yes, we have some on our twice-weekly Zoom calls who are on Vyloy. Some see little side effects from it... others do find it a rough immunotherapy treatment. This is also true for Keytruda and Opdivo and Yervoy and Herceptin and Ramu... but less so. Vyloy does seem to be a tougher regimen.

Gary

Vyloy is a newly approved immuno-oncology agent directed against the Claudin 18.2 cell surface antigen with peripheral interference of HER+. It's been shown to be quite effective in treating patients with advanced, and inoperable G/GEJ adenocarcinoma patients when used in conjuction with fluropyrimidine and oxyplatin based chemotherapies.

The side effects profile is burdensome to say the least.

I've included the warnings and precautions section of it's package insert.

WARNINGS AND PRECAUTIONS
Hypersensitivity reactions, including serious anaphylaxis reactions, and serious and fatal infusion-related reactions (IRR) have been reported in clinical studies when VYLOY has been administered. Any grade hypersensitivity reactions, including anaphylactic reactions, occurring with VYLOY in combination with mFOLFOX6 or CAPOX was 18%. Severe (Grade 3 or 4) hypersensitivity reactions, including anaphylactic reactions, occurred in 2% of patients. Seven patients (1.3%) permanently discontinued VYLOY for hypersensitivity reactions, including two patients (0.4%) who permanently discontinued VYLOY due to anaphylactic reactions. Seventeen (3.2%) patients required dose interruption, and three patients (0.6%) required infusion rate reduction due to hypersensitivity reactions. All grade IRRs occurred in 3.2% in patients administered VYLOY in combination with mFOLFOX6 or CAPOX. Severe (Grade 3) IRRs occurred in 2 (0.4%) patients who received VYLOY. An IRR led to permanent discontinuation of VYLOY in 2 (0.4%) patients and dose interruption in 7 (1.3%) patients. The infusion rate was reduced for VYLOY for 2 (0.4%) patients due to an IRR. Monitor patients during infusion with VYLOY and for 2 hours after completion of infusion or longer if clinically indicated, for hypersensitivity reactions with symptoms and signs that are highly suggestive of anaphylaxis (urticaria, repetitive cough, wheeze and throat tightness/change in voice). Monitor patients for signs and symptoms of IRRs including nausea, vomiting, abdominal pain, salivary hypersecretion, pyrexia, chest discomfort, chills, back pain, cough and hypertension. If a severe or life-threatening hypersensitivity or IRR reaction occurs, discontinue VYLOY permanently, treat symptoms according to standard medical care, and monitor until symptoms resolve. For any Grade 2 hypersensitivity or IRR, interrupt the VYLOY infusion until Grade ≤1, then resume at a reduced infusion rate for the remaining infusion. Follow Grade 2 management for Grade 3 infusion-related nausea and vomiting. Premedicate the patient with antihistamines for the subsequent infusions, and closely monitor the patient for symptoms and signs of a hypersensitivity reaction. The infusion rate may be gradually increased as tolerated.

Severe Nausea and Vomiting. VYLOY is emetogenic. Nausea and vomiting occurred more often during the first cycle of treatment. All grade nausea and vomiting occurred in 82% and 67% respectively of patients treated with VYLOY in combination with mFOLFOX6 and 69% and 66% in combination with CAPOX, respectively. Severe (Grade 3) nausea occurred in 16% and 9% of patients treated with VYLOY in combination with mFOLFOX6 or CAPOX respectively. Severe (Grade 3) vomiting occurred in 16% and 12% of patients treated with VYLOY in combination with mFOLFOX6 or CAPOX. Nausea led to permanent discontinuation of VYLOY in combination with mFOLFOX6 or CAPOX in 18 (3.4%) patients and dose interruption in 147 (28%) patients. Vomiting led to permanent discontinuation of VYLOY in combination with mFOLFOX6 or CAPOX in 20 (3.8%) patients and dose interruption in 150 (28%) patients. Pretreat with antiemetics prior to each infusion of VYLOY. Manage patients during and after infusion with antiemetics or fluid replacement. Interrupt the infusion, or permanently discontinue VYLOY based on severity.

ADVERSE REACTIONS

Most common adverse reactions (≥15%): Nausea, vomiting, fatigue, decreased appetite, diarrhea, peripheral sensory neuropathy, abdominal pain, constipation, decreased weight, hypersensitivity reactions, and pyrexia.

Most common laboratory abnormalities (≥15%): Decreased neutrophil count, decreased leucocyte count, decreased albumin, increased creatinine, decreased hemoglobin, increased glucose, decreased lymphocyte count, increased aspartate aminotransferase, decreased platelets, increased alkaline phosphatase, increased alanine aminotransferase, decreased glucose, decreased sodium, decreased phosphate, decreased potassium, and decreased magnesium.

@bsflint my husband was diagnosis with stage 4 esophageal cancer the end of May. We are almost finished with the 3rd cycle of treatment and will be re scanning in a few weeks. It is so encouraging to hear your story of 4 years since your diagnosis. I have not heard many “success” story, my heart needed this hope as we navigate our new normal. Praying for continued healing for you.

@jmaaccg I would be happy to share my experience/story. If you have any questions, please don’t hesitate to ask. I was diagnosed in 2021, went through radiation to shrink the tumor in my esophagus and then started a chemotherapy regiment that consisted of 12 treatments. They added Opdivo on the 3 treatment when it was FDA approved for GI cancer. After the 12 chemotherapy treatments I continued the Opdivo treatments for several years. I had a reoccurrence in Oct 2023 that was treatment with radiation. And then a second reoccurrence a few months ago which triggered my oncologist to setup a second chemotherapy treatment plan. We have discontinued the Opdivo since it failed. I contribute the “success” to the Opdivo and most importantly the power of prayer. I pray your husband sees positive results in his scan. Keep the fight!

@davidwrenn I have noticed several changes, previously my neuropathy with only for a few days after treatment and I could control using Moxa, now it has gotten more intense and stays continually with this weird feeling in my feet were it feels like someone squeezing both feet at the same time with a slight tugging feeling. My energy level is still not were it was prior to my Vyloy infusion. I had only one Vyloy treatment and went back to Keytruda. On the bright side I have been given some additional options surgery is now an option potentially for me since my last PET scan showed huge improvement. Its weird for a stage four cancer diagnosis I am actually a pretty healthy guy, most people are shocked when they hear about my current situation. I do have a another question has anyone tried T cell treatment?

@jmaaccg When I met my radiologist she was less than hopeful for my life expectancy and said I had to much lymph node action with my esophagus cancer growth which at that time had me having great difficulty eating I most survived off bottles of ensure, I was loosing a half pound per day, my oncologist treated me with the Fullfox chem (probably spelled wrong) and the Keytruda. My cancer and lymph nodes have shrunk were I can eat fairly normal though my appetite is greatly diminished, but I went from being considered too cancer affected to now we are discussing potential surgical options. Its not been an easy run I have had over 13 treatment which I get every two weeks, but hey I am still here I still work, luckily its an at home consulting job and I still do yard work and maintenance on my house, it just takes me longer because I need to rest but Im still doing my best to stay active. All I can say is have faith, smile even when its hard to smile god bless, and stay strong.