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Pembro + Axitinib for mRCC: Dealing with
My mother has advanced Renal Cell Carcinoma (RCC) with metastases to the bones, lungs, and liver.
She started Pembrolizumab (Keytruda) + Axitinib (Inlyta) back in March. The great news is that after just 1 cycle, her immense nerve compression pain stopped completely, so we know the treatment is doing its job.
However, ever since her 2nd cycle, she has been experiencing debilitating episodes of immense stomach cramps and severe gas. During these flare-ups, she can barely eat.
Our current management:
We give her over-the-counter/prescribed gastric medicines.
We temporarily stop the Axitinib for a few days during the peak of the cramps.
After about 3–4 days of holding the Axitinib, the symptoms subside and she gets better, but then the cycle repeats once she starts back up.
Has anyone else dealt with this specific GI issue on this combo? How do you manage the cramping and gas better without constantly di
Answers (14)
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Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
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Will help you
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kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
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Severe GI cramps may be an adverse effect of Axitinib or immune-related colitis from Pembrolizumab. Please inform the treating oncologist promptly. Dose interruption/reduction and evaluation for immune-mediated toxicity may be required.
Next Steps
Oncology review, CBC, LFT, stool evaluation if indicated, and urgent assessment if severe pain, diarrhea, fever, or blood in stools develops.
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Proper evaluation and personalised advice are needed for your concern. A detailed consultation would be best to provide accurate guidance.
Feel free to consult me for further assistance.
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What you are describing â cramping and gas that resolves when Axitinib is held and returns when restarted â is a classic pattern of Axitinib-related GI toxicity, which is one of its most common side effects. The good news is that this is a well-recognized and manageable issue. The standard approach when this becomes a recurring cycle of hold-and-restart is to formally request a dose reduction of Axitinib from the treating oncologist â Axitinib has approved lower doses for exactly this reason, and many patients tolerate a reduced dose much better while still maintaining the anti-tumor effect. Additionally, if there is any possibility of immune-related colitis from Pembrolizumab (which can look similar but tends to be more persistent), the oncologist needs to rule that out as it requires a different management approach including possible steroids.
Next Steps
Speak with the treating oncologist urgently to discuss a formal Axitinib dose reduction, rather than repeatedly holding and restarting â this is a medically supported strategy for managing this side effect. Please consult me directly on Practo for a detailed evaluation.
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It would be waise to consult her gastroenterologist/oncologist team
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Discuss about this oncologist.
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Better to consult a doctor
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go gastro oncologist
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Dr Sakshi
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SHE IS NOT A CASE FOR OPEN PLATFORM. CONSULT SUPERSPECIALIST LIKE GASTROENTEROLOGIST/MD PHYSICIAN.
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It would be better to consult gastro onco _surgeon
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. R S Disodia
General Physician
31 yrs exp
Gurgaon
These medications May cause Gastritis so
Tab Rantidine 300 mg 1 tab x bd+ Syp Antacid 2 tag x tds
After consulting with your Oncologist
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Dr. Shaikh Huzaif
General Physician
20 yrs exp
Mumbai
Please consult
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Dr. Anuj Mothsra
General Physician
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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