LuciTivo (Tivozanib)

About Tivozanib

Tivozanib  is a medication used for the treatment of advanced renal cell carcinoma (kidney cancer).It is an oral VEGF receptor tyrosine kinase inhibitor.

Renal Cell Carcinoma

Indicated for relapsed or refractory advanced renal cell carcinoma in patients previously treated with ≥2 systemic therapies

1.34 mg PO qDay on Days 1-21 of repeated 28-day cycles

Continue until disease progression or unacceptable toxicity

Dosage Modifications

If dose modifications are required for adverse reactions, reduce to 0.89 mg qDay for 21 days followed by 7 days off treatment

Initiate medical management for diarrhea, nausea, or vomiting prior to dose interruption or reduction

Hypertension

• Grade 3

  • Withhold for persistent Grade 3 despite optimal antihypertensive therapy
  • Resume at reduced dose when hypertension controlled at Grade ≤2

• Grade 4

  • Permanently discontinue

Cardiac failure

• Grade 3

  • Withhold until improves to Grade ≤1 or baseline
  • Resume at reduced dose or discontinue depending on severity and persistence

• Grade 4

  • Permanently discontinue

Arterial thromboembolic events or reverse posterior leukoencephalopathy syndrome (RPLS)

• Any grade: Permanently discontinue

Hemorrhagic events

• Grade 3 or 4: Permanently discontinue

Proteinuria

• 2 grams or greater proteinuria in 24 hr

  • Withhold until less than or equal to 2 grams of proteinuria per 24 hr
  • Resume at a reduced dose
  • Permanently discontinue for nephrotic syndrome

Other adverse reactions

• Persistent or intolerable Grade 2 or 3 OR Grade 4 laboratory abnormality

  • Withhold until improves to Grade ≤1 or baseline; resume at reduced dose

• Grade 4

  • Permanently discontinue

Renal impairment

• Mild-to-severe (CrCl 15-89 mL/min): No dosage modifications
• End-stage renal disease: Recommend dose not established

Hepatic impairment

• Mild (total bilirubin [TB] ≤1.5x ULN with any AST): No dosage adjustment necessary
• Moderate (TB >1.5 to 3x ULN with any AST): Reduce to 0.89 mg qDay
• Severe (TB 3 to 10x ULN with any AST): Not established

Dosing Considerations

Verify pregnancy in females of reproductive potential before initiation