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Metastatic bladder cancer spread to liver and other places
Hello,
Does anyone have experience with Padcev? Hubby has had tumor fever for a good month and just started Padcev after Cisplatinum and then Keytruda. No luck with Keytruda. He sleeps a lot and has fever every day. Just wondering what we can expect with the Padcev. Than you!
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2 Replies
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Thank you for the information Joe! I appreciate the feedback.
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I think it is best to contact your doctor if you are concerned with any side effect of PADCEV.
I do not have any experience with Padcev. But I know some about it and its associated side effects. Pacdev is a targeted chemotherapy. It works differently from Cisplatin systemic chemotherapy and Keytruda systemic PD-1 checkpoint inhibitor based immunotherapy. Padcev belongs to Antibody-Drug Conjugate. It uses synthesized antibodies as delivery vehicles which attach specifically to the cell which expresses Nectin-4 proteins on its cell membrane. Once it reaches the target cell, which are highly expressed on the cell membrane of bladder cancer. Once Padcev reaches the target cell, it releases highly toxin called MMAE into the cell. MMAE, which disrupts microtubule dynamics during cell division cycle, will lead the cell to cell cycle arrest and apoptosis (self programmed death). Bladder cancer cells are known to express Nectin-4 protein on its cell membrane. This is why Padcev works for bladder cancer. Unfortunately, Nectin-4 protein is expressed on healthy cells of tissues of other organs, including for example. skin, digestive system, bone marrow, pancreas etc. Padcev will attack healthy cells of those organs and that is the root cause of side effects.
If cells of bone marrows are attacked, red blood cells and white blood cells which are produced in bone marrows will decrease. Red blood cells carry oxygen. Oxygen and glucose are consumed by mitochondria which generate energy used in our body. This may lead to tiredness. If white blood cells are reduced it weakens the immune system. Perhaps, you can request for a blood test which checks red blood cell / hemoglobin, platelet counts and white blood cell counts.
Fever can be caused by various reasons such as inflammation which are the result of PADCEV treatment.
Below is the list of expected side effects and recommended actions by the Ontario Province Healthcare system in Canada. I have found the list is well explained. What to do with fever is extensively explained.
https://www.cancercareontario.ca/en/drugformulary/drugs/infosheet/73996
Similar information from University of Pittsburgh Cancer Center.
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