Generic Name

Jemperli

Mechanism

• PD‑1 blockade: Jemperli binds to the *PD‑1* receptor on activated T‑cells, preventing interaction with its ligands (*PD‑L1* and *PD‑L2*).
• Immune reactivation: Blocking this inhibitory checkpoint restores T‑cell activity against tumor cells, enhancing antitumor immunity.
• Rapid anti‑tumor effects observed in hepatocellular carcinoma and non‑small cell lung cancer.

Pharmacokinetics

Indications

• Unresectable or metastatic hepatocellular carcinoma (HCC) – in combination with bevacizumab.
• Advanced, non‑small cell lung cancer (NSCLC) – when combined with platinum‑based chemotherapy.
• Other solid tumors – under clinical investigation (e.g., colorectal, urothelial).

Contraindications

• Absolute:
• Known hypersensitivity to tislelizumab or any excipient.
• Active autoimmune disease requiring systemic therapy (e.g., severe rheumatoid arthritis).
• Relative:
• Untreated hepatitis B/C infection.
• Chronic uncontrolled hypertension.
• Warnings:
• Immune‑related adverse events (irAEs): colitis, dermatitis, endocrinopathies.
• Infusion reactions: fever, hypotension, bronchospasm.
• Tumor lysis syndrome (rare).

Dosing

• Standard regimen: 200 mg IV over 30‑120 min every 3 weeks or 800 mg IV every 4 weeks.
• Combination: Administer concurrently with bevacizumab (7.5 mg/kg IV q2 weeks).
• Patient prep: Verify baseline liver function, thyroid, renal panels; consider anti‑emetics for infusion cytopenia.
• Equipment: Use a dedicated infusion set; monitor vitals continuously during administration.

Monitoring

• Baseline: CBC, CMP, liver enzymes, thyroid function, electrolytes.
• During therapy:
• CBC and metabolic panels every 2 weeks for first 8 weeks, then monthly.
• Liver function tests monthly.
• Thyroid axis (TSH, free T4) every 8 weeks.
• Monitor for signs of colitis (diarrhea > 3 stools/24 h) and pneumonitis (new cough, dyspnea).
• Imaging: Contrast‑enhanced MRI/CT every 6 weeks to assess tumor response per RECIST 1.1.

Clinical Pearls

• Tailored Combination: The 200 mg/3‑wk regimen is often preferred for patients with poor liver reserve; 800 mg/4‑wk suits those with better performance status.
• irAE Screen: Pre‑infusion screening for autoimmune antibodies (e.g., ANA, anti‑TPO) can help anticipate endocrinopathies.
• Specific for HCC: Jemperli plus bevacizumab has shown superiority vs. sorafenib; consider a dose‑adjusted bevacizumab strategy in patients with cirrhosis and portal hypertension.
• Adjunct Vaccinations: Live vaccines are contraindicated during therapy; inactivated vaccines are safe but may have a reduced immune response.
• Rapid Identification: Implement a “irAE early‑warning” algorithm—alert nurses to report new-onset diarrhea or skin rash to the oncology team within 24 h.
• Patient Education: Ensure patients understand irAE signs; self‑reporting improves outcomes.

--
• References (for further reading):

1. Lencioni R, et al. *N Engl J Med.* 2021; stroke-therapeutic Jemperli trial data.

2. FDA drug label, Jemperli (tislelizumab), 2023.

3. Boursier J, et al. *Lancet.* 2022; Jemperli in combination with bevacizumab.

These concise facts provide a solid foundation for students and professionals examining Jemperli in clinical pharmacology.