Chapter 1: Emergency contact details

(1)

Chapter 1: Emergency

contact details

Merck Sharp & Dohme (UK) Limited Registered in England, No. 233687 Registered Office: 120 Moorgate,London, United Kingdom, EC2M 6UR.

GB-RCC-00167 September 2020 This material has been developed by MSD UK.

Your healthcare team should have provided

you with materials to help you identify any

side effects you may experience on your

treatment. Ensure you read the Patient

Safety Information Brochure and carry your

Patient Alert Card with you at all times.

For patients being treated with KEYTRUDA

®

(pembrolizumab) in combination with

axitinib for advanced renal cell carcinoma

This chapter is part of a series of materials.

For more information, and to access further

materials, please visit

www.KEYTRUDA.co.uk

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at: https://yellowcard.mhra.gov.uk/ or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Merck Sharp & Dohme Limited (tel: 01992 467272). By reporting side effects you can help provide more information on the safety of this medicine.

It is important to be aware of side effects. Telling your healthcare

professional straight away as soon as you notice any symptoms may stop them from becoming more serious.

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This material is intended for patients being treated with KEYTRUDA and axitinib

Emergency contact details

You may find it useful to fill in these details with the

help of your nurse or healthcare provider:

Name:

Main treatment hospital: Consultant: Contact number: Specialist nurse: Contact number: Name of GP: GP Surgery: Contact number: Out of hours helpline:

(3)

Chapter 2: Using your

treatment diary

Merck Sharp & Dohme (UK) Limited Registered in England, No. 233687 Registered Office: 120 Moorgate,London, United Kingdom EC2M 6UR.

Your healthcare team should have provided

you with materials to help you identify any

side effects you may experience on your

treatment. Ensure you read the Patient

Safety Information Brochure and carry your

Patient Alert Card with you at all times.

For patients being treated with KEYTRUDA

®

(pembrolizumab) in combination with

axitinib for advanced renal cell carcinoma

This chapter is part of a series of materials.

For more information, and to access further

materials, please visit

www.KEYTRUDA.co.uk

(4)

This material is intended for patients

being treated with KEYTRUDA and axitinib _{GB-RCC-00189 September 2020}

Your treatment with KEYTRUDA and axitinib

Tell your doctor

right away

if you have

any

of

these side effects

Speak to your healthcare professional immediately if you experience any of the following signs:

General

• Feeling more tired than normal • Feeling confused

• Feeling anxious or irritable • Feeling cold or having chills

or flu-like illness • A fever or hot flushes • Losing or gaining weight • Feeling generally unwell • Having memory problems • Having seizures

• Having trouble sleeping • Noticing a change in

behaviour

Skin and hair

• Changes to the skin or hair • Yellow colour skin

• Skin that looks pale or has lost its colour

• Itchy or dry skin or a rash • Skin blistering, peeling or sores • Ulcers in the mouth or in the

lining of the nose, throat or genital area

• Bleeding or bruising more easily than normal

• Sweating more than normal • Hair falling out

Urine • The amount or colour of urine has changed • Dark or brown colour urine • Needing to urinate more often than usual • Having trouble urinating or suffer from incontinence Eyes • The whites of the eyes become yellow • Changes in eyesight • Double vision • Uncomfortable eyes

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Your treatment with KEYTRUDA and axitinib

Throat and chest

• A new cough or one that gets worse • Deeper voice

• Feeling more short of breath than usual • Chest pain

• Faster or more irregular heart beat

Stomach and bowels

• Feeling less or more hungry than usual

• Feeling nauseous or vomiting

• Constipation, or having trouble going to the toilet

• Diarrhoea or more bowel movements than usual

• A black or sticky stool • Stool with blood or mucus in

• Feeling sore or tender in the stomach area

Mouth and head

• Feeling more thirsty than usual • Feeling faint or dizzy

• Dry mouth

• Noticing changes to sense of taste

• Headaches that do not go away or are unusual

Muscles, nerves, joints, arms and legs

• Aching muscles • Stiff neck

• Muscle or joint pains • Muscle weakness

• Swelling or pain in the legs or arms

• Feeling either weakness, numbness, burning, tingling and/or being unable to move arms or legs

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Using your treatment diary

Throat and

chest nerves, joints Muscles, and limbs Urine Stomach and bowels Skin and hair Mouth and head General Eyes Symptoms

Week commencing: Monday

/

How did you feel this week, on a scale of 1-5?

1 2 3 4 5

Very

poor Poor Fair Good goodVery

Do you feel better or worse than last week?

Better Worse Mon

24

Wed

26

Sat

29

Tue

25

Fri

28

Thu

27

Sun

30 x

x

_x

24th

June

2020

It is important to record any symptoms you experience

Use these boxes to record how you feel in general, and to track your progress week by week

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Using your treatment diary

Daily notes

Weekly summary

!

Speak to your healthcare professional IMMEDIATELY if you notice any of the symptoms highlighted on the previous pages. Do NOT wait for your next appointment.

Do NOT attempt to diagnose or treat side effects yourself.

Woke up with very dry throat – talked to nurse

Woke up with very dry throat again – talked to nurse

Back pain – talked to nurse No appetite today

Very hot today – stayed inside Had some soup and went for short walk

Much better today – back is much improved

Monday – Did not feel as tired today, and spent the afternoon walking my dog in the park

Wednesday – Having slept well last night, I went to the gym for a gentle workout

Record any specific details of what happened or how you felt this week, including blood pressure and temperature measurements

Make a note of anything that you did or how you felt each day

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Using your treatment diary

Chapter 3: Treatment

information

Merck Sharp & Dohme (UK) Limited Registered in England, No. 233687 Registered Office: 120 Moorgate, London, United Kingdom EC2M 6UR.

Your healthcare team should have provided

you with materials to help you identify any

side effects you may experience on your

treatment. Ensure you read the Patient

Safety Information Brochure and carry your

Patient Alert Card with you at all times.

For patients being treated with KEYTRUDA

®

(pembrolizumab) in combination with

axitinib for advanced renal cell carcinoma

This chapter is part of a series of materials.

For more information, and to access further

materials, please visit

www.KEYTRUDA.co.uk

(33)

being treated with KEYTRUDA and axitinib GB-RCC-00168 September 2020

Treatment information

You may find it useful to fill in these details with the

help of your nurse or healthcare provider:

Diagnosis:

Staging:

Date of diagnosis:

Treatment plan:

Planned start date:

Date of surgery:

Type of surgery:

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Treatment information

You may find it useful to fill in these details with the

help of your nurse or healthcare provider:

Surgeon:

Oncologist:

Clinical Nurse Specialist: Concurrent medications:

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Treatment information

You may find it useful to fill in these details with the

help of your nurse or healthcare provider:

Medication allergies and reactions:

(36)

Chapter 9:

Getting ready for your

treatment with

KEYTRUDA and axitinib

Merck Sharp & Dohme (UK) Limited Registered in England, No. 233687 Registered Office: 120 Moorgate, London, United Kingdom EC2M 6UR

Your healthcare team should have provided

you with materials to help you identify any

side effects you may experience on your

treatment. Ensure you read the Patient

Safety Information Brochure and carry your

Patient Alert Card with you at all times.

For patients being treated with KEYTRUDA

®

(pembrolizumab) in combination with

axitinib for advanced renal cell carcinoma

This chapter is part of a series of materials.

For more information, and to access further

materials, please visit

www.KEYTRUDA.co.uk

(37)

Getting ready for your treatment

with KEYTRUDA and axitinib

Is there anything I

can do before my

treatment starts?

As part of your treatment for advanced kidney cancer, your doctors have prescribed you 2 medicines:

• KEYTRUDA (also known as

pembrolizumab), a medicine given by infusion, and

• Inlyta (also known as axitinib), which is taken orally. You take these 2 treatments at the same time.

Before starting to take these medicines, it can help to make sure that you are as ready as you can be. You may start your treatment very quickly after your diagnosis and your healthcare team will give you all the information that you need in this time period.

You may find the additional few tips below helpful and, if you have any questions, ask your healthcare team.

Dr Smith

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Getting ready for your treatment

with KEYTRUDA and axitinib

Taking care of your teeth and gums

• It is important to visit your dentist for a check-up before beginning your treatment

• Remember to tell your dentist about the medicines you are going to take as this can help them understand any potential side effects that might happen

• If you are going to have dental treatment (for example root canal work or fillings) this should be done before starting

treatment. Tell your healthcare team if

your dentist has recommended any dental treatment

• Make sure that you brush your teeth twice a day as this can help prevent bleeding gums. It can also help to use a soft tooth brush, alcohol-free mouthwash and a mild toothpaste

Following a healthy, balanced meal plan

• Following a healthy meal plan can help you maintain your strength. For more information, download Chapter 7: Living

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Getting ready for your treatment

with KEYTRUDA and axitinib

Being active

• Being active can make you feel better because it releases hormones that make you feel good • Staying active can also boost your energy levels

and build a routine, which can help you prepare for some possible side effects, such as tiredness

• Being active doesn’t have to mean running marathons.

30 minutes of moderate activity, such as walking or housework, can help boost your fitness

• Before starting exercise, discuss this with your healthcare professional and develop an exercise plan that is suitable for you

Stopping smoking

If you smoke, stopping is the healthiest decision you can make in the days leading up to your treatment

• Stopping smoking has been shown to improve your overall health

• Trying to stop smoking can be very difficult, especially when dealing with the stress of cancer, so talk to a healthcare professional or an NHS support

service for the best chance of success.

• Visit www.nhs.uk/live-well/quit-smoking to learn more (external website*)

*This external link will take you to a third-party website. We do not review or control the content of any third-party site. We do not endorse and are not responsible for the accuracy, content, practices, or standards of any third-party sources.

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Could it help to have anything at home?

Before you start your treatment, it can be helpful to have key items in your house as these may help with some of the possible side effects. You can speak to your doctor if you have any questions about these items.

Getting ready for your treatment

with KEYTRUDA and axitinib

EPSOM SALTS Mild toothpaste, a soft toothbrush and alcohol-free mouthwash to prevent bleeding gums Epsom salts (for soaking your feet) and preventing cracked skin Gloves for housework, gardening or for manual work Cotton socks or padded insoles for your shoes Tympanic (ear)

thermometer to check your temperature to see if you have an infection

Moisturiser and urea-based creams for your hands, skin and face An electronic blood pressure monitor to check your blood pressure at home GB-RCC-00186 September 2020

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Getting ready for your treatment

with KEYTRUDA and axitinib

Your treatment with KEYTRUDA and axitinib consists of

2 separate medicines.

You’ll get KEYTRUDA in your vein through an intravenous drip, or infusion, every 3 weeks. It takes

about 30 minutes to get each

infusion.

Axitinib (XNB) is a red tablet which you take by mouth 2

times a day, 12 hours apart. The

standard axitinib tablet is a 5 mg dose and has a triangular shape.

Sometimes, doctors may change to a different dose of axitinib, which will have a different shaped tablet. Your doctor, nurse or pharmacist will let you know the exact dose of axitinib that you will receive and how to take them.

1–4 days before each KEYTRUDA infusion, you will have a blood test to make sure you are well enough to receive your treatment. Depending on the results of your blood test you may have to pause or stop your treatment. Your healthcare team will let you know when and where your blood test will be.

XNB

12 hours apart

After your doctor prescribes your treatment, a member of your healthcare

team will help you to book your first appointment for a KEYTRUDA infusion.

Do I have to book my first infusion?

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Regularly attending a hospital to get your KEYTRUDA

infusions can be overwhelming and leave you with

lots of practical questions about how to fit these

appointments into your daily life.

Below are some questions about your infusion that you might want to ask your healthcare team when booking your appointment. They can help explain the process and allow you to plan ahead.

This is not a full list and everyone has different questions, so think about what you would find most useful.

Q: How long do I have to arrive at the hospital before my

first appointment?

Q: Can I bring someone with me?

Q: Do I need to do anything to prepare for the infusion? Q: Can I eat and/or drink before my infusion?

Q: How long will I have to stay at the hospital after my

infusion?

Q: How will I feel immediately afterwards?

Getting ready for your treatment

with KEYTRUDA and axitinib

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Getting ready for your treatment

with KEYTRUDA and axitinib

Q: Can I drive home from the hospital?

Q: Can I do activities or go back to work after my infusion

appointment?

Q: Can I reschedule my infusion appointment if I am busy

or away?

Q: Can I schedule my appointment for the same day that I

pick up my axitinib tablets?

References

1. Macmillan Cancer Support. Available at https://www.macmillan.org.uk/ (Accessed September 2020)

2. Cancer Research UK. Available at https://www.cancerresearchuk.org/ (Accessed September 2020)

3. INLYTA. Summary of Product Characteristics. (Last updated November 2019) 4. KEYTRUDA 50 mg powder for concentrate for solution for infusion - Summary of

Product Characteristics (Last updated August 2020)

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Notes

(45)

Notes

(46)

Chapter 10:

Your treatment with

KEYTRUDA and axitinib

Your healthcare team should have provided

you with materials to help you identify any

side effects you may experience on your

treatment. Ensure you read the Patient

Safety Information Brochure and carry your

Patient Alert Card with you at all times.

For patients being treated with KEYTRUDA

®

(pembrolizumab) in combination with

axitinib for advanced renal cell carcinoma

This chapter is part of a series of materials.

For more information, and to access further

materials, please visit

www.KEYTRUDA.co.uk

(47)

Why do the

medicines have 2 names?

Many medicines are known by different names. Usually, a medicine has 2 names:

• A brand name • A generic or medical name For example, KEYTRUDA is the brand

name, and pembrolizumab is the generic name.

Your treatment with

KEYTRUDA and axitinib

As part of your treatment for

advanced kidney cancer, your doctors prescribed you 2 medicines:

• KEYTRUDA (also known as

pembrolizumab), a medicine given by infusion, and

• Inlyta (also known as axitinib), which is taken orally

You take these 2 treatments at the same time.

Dr Smith

(48)

Your treatment with KEYTRUDA and axitinib

2

1

3 How KEYTRUDA works

The immune system is your body’s natural defence against disease. It sends immune cells throughout your body to seek out cancer cells and destroy them.

KEYTRUDA blocks these signals. This helps your immune system do what it’s meant to: detect and destroy the cancer cells.

However, some cancer cells can make signals which let them hide from our immune system. This stops the immune system from attacking cancer cells and lets cancer cells grow and spread.

What is KEYTRUDA (pembrolizumab) and how

does it work?

Normally, our bodies are good at finding cancer and destroying it. However, some cancers can send out signals which help them hide from our immune systems. This lets cancer cells grow and spread. KEYTRUDA is a type of cancer treatment called immunotherapy.

Immunotherapy works with your immune system to help fight cancer.

Cancer Cell Cancer Cell Immune Cell Cancer Cell Cancer Cell Immune Cell Cancer Cell Immune Cell Cancer Cell Cancer Cell Immune Cell Cancer Cell Cancer Cell Immune Cell Cancer Cell Immune Cell Cancer Cell Cancer Cell Immune Cell Cancer Cell Cancer Cell Immune Cell Cancer Cell Immune Cell

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Your treatment with KEYTRUDA and axitinib

2

1 What is Inlyta (axitinib) and how does it work?

How axitinib works

Inlyta (axitinib) is a TKI, which is a type of drug that can stop blood supply to cancer cells. This means cancer cells don’t have food and oxygen, which causes them to die.

Blood vessel

Cancer Cell Cancer Cell

Blood vessel

Cancer Cell Cancer Cell

Cancers can send out signals which cause new blood vessels to grow towards the cancer.

Axitinib can block these signals. This stops blood vessels from growing towards the cancer and starves cancer cells of food and oxygen.

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Your treatment with KEYTRUDA and axitinib

How do I take my treatment?

You’ll get KEYTRUDA in your vein through an intravenous drip, or infusion, every 3 weeks. It takes about 30 minutes to get each infusion.

Nurses will help connect the drip and make sure that the solution is flowing correctly and safely.

Axitinib (XNB) is a red tablet which you taken by mouth

2 times a day, 12 hours apart. The standard axitinib tablet

is a 5 mg dose and has a triangular shape.

Sometimes, doctors may change to a different dose of axitinib, which has a different shaped tablet. Your doctor, nurse or pharmacist will let you know the exact dose of axitinib that you will receive.

XNB

Why do I have to take

KEYTRUDA and axitinib

together?

KEYTRUDA and axitinib affect

2 different ways that cancer

grows, which has been shown

to be a good method to keep the

cancer under control.

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Your treatment with KEYTRUDA and axitinib

KEYTRUDA

HOW?

Infusion

Tablet, by mouth

WHEN?

1 time every

_{3 weeks}

2 tablets a day,

_{12 hours apart}

WHERE?

administered

In clinic

by a nurse

At home

Axitinib

XNB

How long will my treatment last?

You’ll take this treatment for as long as doctors think it is still working to fight the cancer, up to a maximum of 2 years. In some cases, doctors may pause treatment for

a while so you can recover from side effects but this doesn’t mean your treatment will permanently stop.

If side effects continue or get worse, doctors may choose to stop treatment earlier. Your doctors will talk about this with you before making any decisions.

In certain circumstances, where the side effects can be managed by having breaks from your treatment, this will be done while monitoring and managing these side effects before they get worse. In other circumstances, the treatment will have to be stopped. Your healthcare team will discuss this with you. Always let your healthcare team know if you are experiencing any side effects.

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Your treatment with KEYTRUDA and axitinib

What are the side effects of taking

KEYTRUDA and axitinib?

Like all medicines, KEYTRUDA can cause side effects. Although not everybody gets them, it is important to look out for any signs and/or symptoms. Side effects can appear soon after starting treatment. But they can also occur at any time and up to

3 months after your treatment stops. Tell your doctor about your

side effects early so they have more time to care for them. It’s important to know the side effects and report them to your doctors right away before they get worse or affect your treatment.

It is also possible to experience more

than one side effect at

a time.

On the next page is a diagram of the major symptoms

you should look out for.

Speak to your healthcare professional IMMEDIATELY

if you notice any of these symptoms.

Do NOT wait for your next appointment.

Do NOT attempt to diagnose or treat side effects

yourself.

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Your treatment with KEYTRUDA and axitinib

Tell your doctor

right away

if you have

any

of

these side effects

Speak to your healthcare professional immediately if you experience any of the following signs:

General

• Feeling more tired than normal • Feeling confused

• Feeling anxious or irritable • Feeling cold or having chills

or flu-like illness • A fever or hot flushes • Losing or gaining weight • Feeling generally unwell • Having memory problems • Having seizures

• Having trouble sleeping • Noticing a change in

behaviour

Skin and hair

• Changes to the skin or hair • Yellow colour skin

• Skin that looks pale or has lost its colour

• Itchy or dry skin or a rash • Skin blistering, peeling or sores • Ulcers in the mouth or in the

lining of the nose, throat or genital area

• Bleeding or bruising more easily than normal

• Sweating more than normal • Hair falling out

Urine • The amount or colour of urine has changed • Dark or brown colour urine • Needing to urinate more often than usual • Having trouble urinating or suffer from incontinence Eyes • The whites of the eyes become yellow • Changes in eyesight • Double vision • Uncomfortable eyes GB-RCC-00187 September 2020

(54)

Your treatment with KEYTRUDA and axitinib

Throat and chest

• A new cough or one that gets worse • Deeper voice

• Feeling more short of breath than usual • Chest pain

• Faster or more irregular heart beat

Stomach and bowels

• Feeling less or more hungry than usual

• Feeling nauseous or vomiting

• Constipation, or having trouble going to the toilet

• Diarrhoea or more bowel movements than usual

• A black or sticky stool • Stool with blood or mucus in

• Feeling sore or tender in the stomach area

Mouth and head

• Feeling more thirsty than usual • Feeling faint or dizzy

• Dry mouth

• Noticing changes to sense of taste

• Headaches that do not go away or are unusual

Muscles, nerves, joints, arms and legs

• Aching muscles • Stiff neck

• Muscle or joint pains • Muscle weakness

• Swelling or pain in the legs or arms

• Feeling either weakness, numbness, burning, tingling and/or being unable to move arms or legs

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Your treatment with KEYTRUDA and axitinib

Your patient alert card

When your doctor prescribes you KEYTRUDA and axitinib, they will give you a patient alert card. It is important to keep

this card with you at all times, particularly if you are away

from home. Your card contains:

• Information about your treatment • A list of the common side effects • Important contact information

If you do notice any of the side effects shown above and you need visit A&E, show this card to a healthcare professional so that can quickly diagnose the problem and order the correct tests.

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Tips for managing side effects whilst on KEYTRUDA

and axitinib

Whilst you are taking KEYTRUDA and axitinib, these tips can help you deal with side effects and support your recovery:

Follow a healthy meal plan

For more information on following a balanced diet, download

Chapter 7: Living with kidney cancer

Be active

For more information on exercise, download Chapter 9: Getting

ready for your treatment with KEYTRUDA and axitinib

Take care of your teeth and gums

To keep your mouth healthy and prevent bleeding gums: • Brush your teeth 2 times a day with a soft toothbrush and

mild toothpaste

• Rinse your mouth with alcohol-free mouthwash

Take care of your skin

Moisturising your hands, feet, and face at least 2 times a day can help prevent skin problems. If you do housework, gardening, or manual work, wear gloves to protect your hands.

Take your blood pressure

Nurses will take your blood pressure both before and during treatment. You can also take your blood pressure at home using a monitoring device.

Your treatment with KEYTRUDA and axitinib

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Your treatment with KEYTRUDA and axitinib

Important points to remember whilst taking

your KEYTRUDA and axitinib treatment

Book doctor appointments on the days you pick up axitinib

Axitinib is prescribed in packs of 56 (enough for 4 weeks). Talk to your doctor about booking appointments on the days you pick up your axitinib tablets to avoid extra trips.

Talk to your doctor about taking other medicines

Before taking any other medicines, including

antibiotics or painkillers, talk to your doctor or pharmacist to make sure you are okay to take them with your treatment.

Before taking vitamins or herbal supplements,

talk to your doctor in case the vitamins or supplements could change how your treatment works.

Do not take St John’s wort whilst on treatment

with KEYTRUDA and axitinib.

Avoid immunisation with live vaccines during

treatment. Talk to your doctor or pharmacist before any vaccinations.

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Your treatment with KEYTRUDA and axitinib

Avoid certain foods and drinks

Avoid eating grapefruit, or drinking juices with grapefruit juice, because they may increase the chance of side effects.

Limit or stop drinking alcohol.

Axitinib tablets contain lactose which may affect some people with a lactose intolerance. If you are lactose intolerant, tell your doctor before your treatment.

Fertility and children

For men, do not get your partner pregnant during treatment with KEYTRUDA and axitinib. If you plan to be sexually active, talk to your doctors about birth control. For women, talk to your doctors about if you are thinking about pregnancy or have already given birth. They can give more information on birth control and options for breastfeeding.

XNB

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Your treatment with KEYTRUDA and axitinib

References

1. Keytruda 50 mg powder for concentrate for solution for infusion. Summary of Product characteristics. (Last updated August 2020)

2. Inlyta 1 mg film-coated tablets. Summary of Product characteristics. (Last updated November 2019)

4. Keytruda Patient Information Leaflet (PIL). Available from: https://www. medicines.org.uk/emc/medicine/33163. (Accessed September 2020)

5. Inlyta Patient Information Leaflet (PIL). Available from: https://www.medicines. org.uk/emc/product/4325/pil (Accessed September 2020)

6. Your Keytruda Treatment. Available from: http://www.keytruda.co.uk/patient-pages/your-keytruda-treatment (Accessed September 2020)

(60)

Notes

(61)

Notes

(62)

FAQs

Your healthcare team should have provided

you with materials to help you identify any

side effects you may experience on your

treatment. Ensure you read the Patient

Safety Information Brochure and carry your

Patient Alert Card with you at all times.

For patients being treated with KEYTRUDA

®

(pembrolizumab) in combination with

axitinib for advanced renal cell carcinoma

This chapter is part of a series of materials.

For more information, and to access further

materials, please visit

www.KEYTRUDA.co.uk

DO NOT ATTEMPT TO DIAGNOSE OR TREAT SIDE EFFECTS YOURSELF.

Chapter 11:

Frequently asked questions

about your treatment with

KEYTRUDA and axitinib

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Frequently asked questions about

your treatment with

KEYTRUDA and

axitinib

Taking KEYTRUDA

FAQs

It is normal to have

lots of questions about

your treatment and the

lifestyle changes you may

have to make.

While this list covers

some common questions,

it is important to talk to a

healthcare professional

if you are worried about

any aspect of your

treatment.

Q: How long does an _{infusion take?}

• Once your nurse has helped to

connect the drip, each infusion takes 30 minutes. You may be at the infusion unit for up to 2 hours in total.

Q: What should I do if I can’t get to my infusion appointment?

• If you miss an infusion appointment, or you know you won’t be able to make it in future - call your doctor or clinic right away who will help you reschedule your appointment

• It is very important that you do not miss a dose of this medicine unless your healthcare professional has told you otherwise

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Frequently asked questions

Taking axitinib

Q: Can I eat before taking my axitinib tablets?

• Axitinib can be taken with or without food, 12 hours apart. Tablets should be swallowed whole with a glass of water

Q: What should I do if I took too many tablets?

• If you accidentally take too many tablets or a higher dose than you need, contact your healthcare team for advice right away

Q: What should I do if I forgot to take my tablets?

• If you miss a dose, take the next dose at the usual time

Q: I was sick soon after taking my axitinib tablets, what should I do?

• If you are sick, do not take another dose. Take the next dose at the usual time

• If you feel very unwell, or you are throwing up, contact a healthcare professional immediately as vomiting may be a sign of a more serious side effect

Q: Why are my axitinib tablets different shapes?

• The standard dose (5 mg) of axitinib is a red triangular shape • If they think it is best for you, your doctor may decide to alter

the dose you receive and it could go up or down

• The other shapes of axitinib are a round shape (for the 3 mg dose) and an oval shape (for the 1 mg dose)

• For more information about axitinib, talk to your healthcare professional, your pharmacist or visit https://www.medicines. org.uk/emc/files/pil.4325.pdf

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Frequently asked questions

Q: I am already taking medication for another condition; can I continue these treatments?

• Before starting your treatment, your healthcare team will ask you what other medications you are already taking and give you personalised advice about whether they need to be stopped or not • It is important to tell a healthcare professional

before you start taking any other prescribed or over-the-counter medicines, for example, paracetamol and antibiotics

Always discuss any vaccine or medicine with a healthcare professional first

Other medications

Q: Can I get a flu vaccine whilst on treatment

• Always discuss any vaccine or medicine with a healthcare professional first. Your healthcare team may recommend a flu vaccination if they think you are at particular risk. Flu vaccines do not contain a live virus so are considered suitable for patients receiving

KEYTRUDA and axitinib

Q: What vaccinations am I able to get?

• Whilst receiving KEYTRUDA and axitinib, it is not recommended to have a ‘live’ vaccine

• In the UK, live vaccines include measles, mumps, rubella, yellow fever and the shingles vaccine (Zostavax). Ask a healthcare professional before you have these or any other injections

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Frequently asked questions

Food and drink

Q: Do I need to change my diet whilst on treatment?

• While you can continue to eat most foods whilst receiving treatment, a balanced and healthy diet will help you to maintain your strength and keep you in good shape

• Your dietician can also provide you with advice about foods which can help you during your treatment

Q: Are there any foods which I should be avoiding whilst on treatment?

• Avoid eating grapefruit or drinking juices which contain grapefruit juice. This is because grapefruit contains a chemical can interfere with how your treatment works

• Axitinib tablets contain lactose. If you are lactose intolerant, talk to your healthcare professional

Q: What should I do if I forgot to take my tablets?

• If you miss a dose, take the next dose at the usual time

Q: Can I still drink alcohol whilst on treatment?

• While alcohol is allowed, cutting down on the amount you drink is recommended while receiving treatment as part of maintaining a healthy lifestyle

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Frequently asked questions

Q: Can I continue to work?

• Your healthcare team will let you know if it’s okay for you to return to work and advise you about tasks which may not be suitable for you

Q: Can I still drive?

• KEYTRUDA has a minor effect on your ability to drive or use machines. Do not drive or use machines after you have been given your KEYTRUDA infusion or after taking axitinib tablets unless you are sure you are feeling well. Talk to your healthcare professional if you are worried about travelling or employment • Feeling dizzy, tired or weak is

a very common side effect of both KEYTRUDA infusions and axitinib, and this can affect your ability to drive

Work and lifestyle

FAQs

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Frequently asked questions

Finding help

Q: Who can I turn to for more help?

• Talking can help you to get the support you need. Having cancer can be emotionally tough, but talking to you family and friends can help increase their understanding

• Help your friends and family by letting them know if you would like to talk about what’s happening and how you feel • If you find it hard to talk to family or friends, you can talk to

someone independent, such as your GP or nurse specialist. • The following helplines are also available:

– Cancer Research UK

www.cancerresearchuk.org Helpline: 0808 800 4040. Mon–Fri 9am–5pm

– Macmillan Cancer Support www.macmillan.org.uk

Macmillan Support Line: 0808 808 00 00 – Kidney Cancer UK & Kidney Cancer Scotland

www.kcuk.org.uk

Patients’ support Careline: 0800 002 9002. Mon–Fri 9am–4pm

– Kidney Cancer Support Network www.kcsn.org.uk

Helpline: 01209 890326. Email: team_@kcsn.org.uk Mon–Fri 10am–4pm

Talking can help you to get

the support you need

References

1. KEYTRUDA 50 mg powder for concentrate for solution for infusion - Summary of Product Characteristics (Last updated August 2020)

2. Inlyta Patient Information Leaflet (last updated in November 2019)

4. Keytruda Patient Information Leaflet (last updated in June 2020)

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Oncologist

Your healthcare team should have provided

you with materials to help you identify any

side effects you may experience on your

treatment. Ensure you read the Patient

Safety Information Brochure and carry your

Patient Alert Card with you at all times.

For patients being treated with KEYTRUDA

®

(pembrolizumab) in combination with

axitinib for advanced renal cell carcinoma

This chapter is part of a series of materials.

For more information, and to access further

materials, please visit

www.KEYTRUDA.co.uk

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Knowing what to ask about

your treatment

Learning that you have been prescribed a new set of medicines can be confusing and overwhelming.

When a doctor says “do you have any

questions?” it can be hard to know what to ask.

Below are some example or suggested questions that you can take to your

appointments and can help you understand more about your treatment and what to expect. This is not a full list of questions, but it can be a guide to help think about the ones which are relevant to you and your treatment.

Dr Smith

Oncologist

Writing down the answers may help you to remember them

ahead of future appointments.

Taking KEYTRUDA and axitinib

Q: When do I start my treatment? Q: How long will I be taking this

treatment for?

Q: How long will it be until my next scan? Q: Can I go back to work?

Q: Can I go on holiday?

Q: What is an immunotherapy? Is it the

same as chemotherapy?

Q: How does immunotherapy work? Q: What is a tyrosine kinase inhibitor

(TKI)? Is it a type of chemotherapy?

Q: How do TKIs work?

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Knowing what to ask about your treatment

Asking about infusions

Q: How often do I have to have infusions? Q: Does the infusion go into my arm? Q: Will the infusion hurt?

Q: How long do I have to arrive at the hospital before my appointment? Q: Am I able to bring someone with me?

Q: How long does an infusion take?

Q: How long will I have to stay at the hospital after my infusion? Q: How will I feel immediately afterwards?

Q: Can I drive home afterwards?

Q: Can I reschedule my infusion appointment if I am busy or away? Q: Can I schedule my appointments for the same day that I pick up

my axitinib tablets?

Q: When do I need to see the consultant again?

?

Q: Is my next appointment with the

consultant on the same day as an infusion?

Q: Should I do anything to prepare for

the infusion?

Q: Am I able to eat and/or drink before

my infusion?

Q: How soon can I eat and/or drink after

my infusion?

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Knowing what to ask about your treatment

Taking axitinib

Q: Where do I pick up my axitinib

tablets?

Q: How many axitinib tablets do I

pick up each time?

Q: Can I eat before taking my

axitinib tablets?

Q: What should I do if I forget to

take my axitinib tablets?

Q: Who should I contact if I run out

of tablets?

Q: Why has my dose changed?

Side effects of KEYTRUDA in

combination with axitinib

Q: Who should I contact first if I

feel unwell?

Q: What side effects am I most

likely to experience?

Q: Are there any side effects which

I really need to look out for?

Q: Can I take anti-sickness tablets

if I feel sick?

?

Writing down the answers may help you to remember them

ahead of future appointments.

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Notes

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