Which patients are suitable for taking ivosidenib?

Ivosidenib is the first approved drug of the IDH1 inhibitor class. It works by inhibiting isocitrate dehydrogenase-1 (IDH1) to reduce the abnormal production of 2-hydroxyglutarate (2-HG).

Which patients are suitable for taking ivosidenib?

Ivosidenib is indicated for adult patients with confirmed isocitrate dehydrogenase-1 (IDH1) gene mutations detected by FDA-approved testing methods, for the treatment of acute myeloid leukemia (AML), cholangiocarcinoma, and myelodysplastic syndromes.

Mutations in the IDH1 gene may lead to the accumulation of the oncogenic metabolite 2-hydroxyglutarate (2-HG). Elevated 2-HG levels can interfere with the differentiation process of immature blast cells into mature cells.

Common adverse reactions of ivosidenib

These adverse reactions occur in more than 10 out of every 100 patients (>10%). You may experience one or more of them, including but not limited to the following symptoms:

Fatigue and asthenia

You may feel extremely tired, as if lacking energy.

There are several ways to help alleviate and manage fatigue, such as exercise. Some studies have shown that moderate physical activity can boost your energy levels. It is crucial to maintain a balance between exercise and rest.

Nausea or vomiting

Nausea or vomiting can usually be well-controlled with antiemetic drugs. Avoiding greasy or fried foods, eating small, frequent meals, and drinking small sips of water regularly may be helpful. Relaxation techniques may also be useful.

It is important to take antiemetic medications as prescribed, even if you do not feel nauseous. Preventing vomiting is much easier than treating it after it starts.

Abdominal pain

Contact your doctor if this symptom occurs. Depending on the underlying cause of the pain, they may prescribe medications to help relieve it.

Uncommon adverse reactions of ivosidenib

These adverse reactions occur in 1 to 10 out of every 100 patients (1–10%). You may experience one or more of them, including:

1. Increased risk of infection (due to decreased white blood cell count):  Symptoms include changes in body temperature, muscle aches, headache, chills and rigors, as well as general malaise. Additional symptoms may occur depending on the site of infection. Infections can sometimes be life-threatening. If you suspect you have an infection, contact your doctor immediately.

2. Bruising, gingival bleeding or epistaxis (due to decreased platelet count): You may also notice numerous small red spots or petechiae on your arms or legs.

3. Yellowing of the skin and eyes (jaundice): Caused by the impaired flow of bile from the liver.

4. Falls

5. Changes in heart rhythm: Contact your doctor if you feel dizzy or faint.