Tevimbra: Uses, Dosage & Side Effects
A PD-1 immune checkpoint inhibitor (monoclonal antibody) used to treat non-small cell lung cancer, small cell lung cancer, gastric cancer, esophageal squamous cell carcinoma, and nasopharyngeal carcinoma
Tevimbra (tislelizumab) is a humanized monoclonal antibody that belongs to the class of immune checkpoint inhibitors targeting the programmed cell death 1 (PD-1) receptor. By blocking PD-1 on the surface of T cells, Tevimbra prevents cancer cells from evading the immune system, thereby restoring the body’s natural ability to recognize and destroy tumors. Tevimbra is approved for the treatment of several advanced or metastatic cancers in adults, including non-small cell lung cancer (NSCLC), extensive-stage small cell lung cancer (ES-SCLC), gastric or gastroesophageal junction adenocarcinoma, esophageal squamous cell carcinoma, and nasopharyngeal carcinoma. It is also approved as neoadjuvant and adjuvant therapy for resectable NSCLC. Tevimbra is administered as an intravenous infusion in a hospital or clinic setting and requires a prescription.
Quick Facts: Tevimbra
Key Takeaways
- Tevimbra (tislelizumab) is a PD-1 immune checkpoint inhibitor that helps the immune system recognize and attack cancer cells by blocking the PD-1 receptor on T cells, preventing tumors from suppressing immune responses.
- It is approved for multiple cancer types in adults: non-small cell lung cancer (both metastatic and as pre/post-surgical treatment), extensive-stage small cell lung cancer, gastric/gastroesophageal junction adenocarcinoma, esophageal squamous cell carcinoma, and nasopharyngeal carcinoma.
- Tevimbra can cause immune-mediated adverse reactions affecting virtually any organ system, including the lungs (pneumonitis), liver (hepatitis), kidneys (nephritis), colon (colitis), thyroid, and skin; patients require regular monitoring throughout treatment.
- Treatment is given as an intravenous infusion at either 200 mg every 3 weeks or 400 mg every 6 weeks, always in a supervised hospital or clinic setting; it may be given alone or in combination with chemotherapy.
- Women of childbearing potential must use effective contraception during treatment and for at least 4 months after the last dose; breastfeeding is not recommended during treatment or for 4 months after the final infusion.
What Is Tevimbra and What Is It Used For?
Tevimbra contains the active substance tislelizumab, a humanized immunoglobulin G4 (IgG4) monoclonal antibody that has been engineered to bind to and block the programmed cell death 1 (PD-1) receptor. PD-1 is a critical immune checkpoint receptor found on the surface of T cells and B cells, which are key components of the adaptive immune system. Under normal physiological conditions, the PD-1 pathway serves as a regulatory brake on immune activity, helping to prevent autoimmune reactions by limiting the duration and intensity of T-cell responses.
Many types of cancer exploit this natural immune checkpoint mechanism to evade detection and destruction by the immune system. Cancer cells can overexpress proteins called PD-L1 (programmed death-ligand 1) and PD-L2 on their surfaces. When these ligands bind to PD-1 on T cells, they effectively “switch off” the T cells, rendering them incapable of attacking the tumor. By occupying the PD-1 receptor, tislelizumab prevents this ligand binding and thereby restores the anti-tumor activity of T cells.
A distinctive feature of tislelizumab compared with some other anti-PD-1 antibodies is that it was specifically engineered to minimize binding to Fc-gamma receptor I (FcγRI) on macrophages. In preclinical models, binding of anti-PD-1 antibodies to FcγRI on macrophages was associated with antibody-dependent phagocytosis (engulfment and destruction) of the very T cells the antibody was intended to activate. By reducing this FcγRI interaction, tislelizumab may help preserve a greater proportion of activated anti-tumor T cells at the tumor site.
Tevimbra is approved by the European Medicines Agency (EMA) and other regulatory authorities for the treatment of the following cancer types in adults:
- Non-small cell lung cancer (NSCLC) – metastatic: Tevimbra is used as monotherapy for patients with locally advanced or metastatic NSCLC whose tumors express PD-L1 and who have received prior chemotherapy, or in combination with platinum-based chemotherapy as first-line treatment regardless of PD-L1 status. NSCLC is the most common type of lung cancer, accounting for approximately 80–85% of all lung cancer cases.
- Non-small cell lung cancer (NSCLC) – neoadjuvant/adjuvant: Tevimbra is given before surgery (neoadjuvant) in combination with platinum-based chemotherapy, and then continued after surgery (adjuvant) as monotherapy, for patients with resectable NSCLC to reduce the risk of cancer recurrence.
- Extensive-stage small cell lung cancer (ES-SCLC): Tevimbra is used in combination with platinum-based chemotherapy (carboplatin or cisplatin) plus etoposide as first-line treatment. Small cell lung cancer is a highly aggressive form that grows and spreads quickly, and ES-SCLC indicates the disease has spread beyond the original site in the lung.
- Gastric or gastroesophageal junction (GEJ) adenocarcinoma: Tevimbra is used in combination with fluoropyrimidine- and platinum-containing chemotherapy as first-line treatment for patients with locally advanced unresectable or metastatic HER2-negative gastric or GEJ adenocarcinoma whose tumors express PD-L1.
- Esophageal squamous cell carcinoma (ESCC): Tevimbra is used as monotherapy or in combination with chemotherapy for patients with unresectable, locally advanced, recurrent, or metastatic ESCC. Esophageal squamous cell carcinoma arises from the lining of the esophagus and is more common in certain geographic regions and populations.
- Nasopharyngeal carcinoma (NPC): Tevimbra is used in combination with cisplatin and gemcitabine as first-line treatment for patients with unresectable, recurrent, or metastatic nasopharyngeal carcinoma. NPC arises from the nasopharynx (the upper part of the throat behind the nose) and is particularly prevalent in Southeast Asia and southern China.
Tevimbra is indicated for patients whose cancer has spread (metastasized), cannot be surgically removed (unresectable), or in the neoadjuvant/adjuvant setting for operable NSCLC. The choice of monotherapy versus combination with chemotherapy depends on the specific cancer type, PD-L1 expression status, and treatment line as determined by the treating oncologist.
Unlike traditional chemotherapy, which directly kills rapidly dividing cells (both cancerous and healthy), Tevimbra works by “releasing the brakes” on the immune system. This means the body’s own T cells are empowered to seek out and destroy cancer cells. While this can lead to durable responses in some patients, it also means that immune-mediated side effects — where the activated immune system attacks healthy tissue — are possible and require vigilant monitoring.
What Should You Know Before Receiving Tevimbra?
Contraindications
There is one absolute contraindication for Tevimbra:
- Hypersensitivity: Do not receive Tevimbra if you are allergic to tislelizumab or any of the other ingredients in the formulation, including sodium citrate, citric acid monohydrate, L-histidine hydrochloride monohydrate, L-histidine, trehalose dihydrate, polysorbate 20, or water for injections. If you are unsure whether you may be allergic to any of these components, speak with your doctor before treatment begins.
Warnings and Precautions
Before starting treatment with Tevimbra, tell your doctor if you have or have ever had any of the following conditions, as they may increase your risk of serious side effects:
- Autoimmune disease: If your body’s immune system attacks your own cells (such as lupus, rheumatoid arthritis, inflammatory bowel disease, or multiple sclerosis), Tevimbra may worsen these conditions or trigger flares because it enhances immune activity.
- Organ transplant: If you have received a solid organ transplant, Tevimbra may increase the risk of organ rejection because the activated immune system may attack the transplanted organ.
- Liver problems: Including hepatitis or other liver conditions, as Tevimbra can cause immune-mediated hepatitis.
- Lung problems: Including pneumonitis or interstitial lung disease, as Tevimbra can cause immune-mediated inflammation of the lungs.
- Kidney problems: Including nephritis, as Tevimbra can cause immune-mediated kidney inflammation.
- Endocrine disorders: Including thyroid problems (hypothyroidism, hyperthyroidism, thyroiditis), adrenal insufficiency, hypophysitis (pituitary gland inflammation), or type 1 diabetes mellitus.
- Severe skin conditions: As Tevimbra can trigger serious skin reactions including Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).
Tevimbra works by enhancing the immune system, which means it can cause inflammation in virtually any organ. Some immune-mediated reactions can be severe or life-threatening. Contact your doctor immediately if you experience: new or worsening cough or shortness of breath (pneumonitis); yellowing of skin/eyes, dark urine, or abdominal pain (hepatitis); decreased urine output or blood in urine (nephritis); severe or persistent diarrhea (colitis); severe skin rashes, blisters, or peeling skin (SJS/TEN); extreme fatigue, rapid heartbeat, weight changes, or feeling cold (endocrinopathies); chest pain, irregular heartbeat, or breathing difficulty at rest (myocarditis/pericarditis); or muscle weakness and pain (myositis).
Your doctor will carry out regular tests and examinations before and during treatment, including blood tests to monitor liver function, kidney function, thyroid hormones, and blood glucose levels. A patient alert card will be provided to you with important safety information — carry it with you at all times and show it to any healthcare professional who treats you.
Pregnancy and Breastfeeding
Tevimbra should not be used during pregnancy unless specifically recommended by your doctor after careful consideration of the risks and benefits. The effects of tislelizumab on the developing fetus have not been studied in humans, but based on its mechanism of action (blocking PD-1, which plays a role in immune tolerance during pregnancy), there is a potential risk of harm to the unborn child, including increased risk of immune-mediated rejection of the fetus.
If you are a woman of childbearing potential, you must use effective contraception during treatment with Tevimbra and for at least 4 months after the last dose. If you are pregnant, think you may be pregnant, or are planning to become pregnant, tell your doctor before starting treatment.
It is not known whether tislelizumab passes into breast milk. A risk to the breastfed infant cannot be excluded. You should not breastfeed during treatment with Tevimbra and for at least 4 months after the last dose. Discuss with your doctor whether the benefits of breastfeeding outweigh the potential risks.
Driving and Operating Machinery
Tevimbra may have a minor effect on your ability to drive and use machines. Fatigue and weakness are possible side effects. If you experience these symptoms after receiving Tevimbra, do not drive or operate machinery until you feel well enough to do so safely.
Important Information About Ingredients
Each mL of Tevimbra concentrate contains 1.6 mg of sodium (the main component of table salt). A single infusion of Tevimbra from two 10 mL vials contains 32 mg of sodium before dilution, which corresponds to approximately 1.6% of the WHO-recommended maximum daily dietary sodium intake for adults. Tevimbra is diluted in sodium chloride infusion solution, which should be taken into account if you are on a sodium-restricted diet. Tell your doctor if you are on a low-sodium diet.
This medicine also contains 0.2 mg of polysorbate 20 per mL of concentrate (4.0 mg total in a standard two-vial dose). Polysorbates can cause allergic reactions in some individuals. Inform your doctor if you have any known allergies to polysorbates.
How Does Tevimbra Interact with Other Drugs?
Tell your doctor about all medications you are currently taking, have recently taken, or may be planning to take. This includes prescription medications, over-the-counter drugs, herbal supplements, and vitamins. The following interactions are particularly important to be aware of:
Major Interactions
| Interacting Drug | Effect | Clinical Significance |
|---|---|---|
| Systemic corticosteroids (e.g., prednisone, dexamethasone) | May suppress immune activation and reduce the anti-tumor efficacy of Tevimbra | Avoid before starting Tevimbra; acceptable for managing immune-mediated side effects during treatment |
| Other immunosuppressive agents (e.g., azathioprine, cyclosporine, methotrexate) | May counteract the immune-activating mechanism of Tevimbra | Avoid concurrent use; discuss alternatives with your oncologist |
| Live vaccines (e.g., MMR, varicella, BCG, yellow fever) | Risk of vaccine-strain infection or unpredictable immune responses | Avoid during treatment; inactivated vaccines may be given but immune response may be reduced |
Minor Interactions
| Interacting Drug | Effect | Clinical Significance |
|---|---|---|
| Other anti-PD-1/PD-L1 antibodies (e.g., pembrolizumab, nivolumab, atezolizumab) | Overlapping mechanism; no clinical benefit expected from combination | Do not combine; switch rather than add |
| Platinum-based chemotherapy (carboplatin, cisplatin) | Approved combination; additive anti-tumor effects with manageable toxicity profile | Commonly co-administered per approved indications; monitor for combined myelosuppression |
| Thyroid replacement therapy (levothyroxine) | No pharmacokinetic interaction; may be needed if Tevimbra causes hypothyroidism | Monitor thyroid function; dose adjustments of levothyroxine may be required |
| Proton pump inhibitors (omeprazole, pantoprazole) | No known direct interaction with tislelizumab | Safe to use concurrently if needed for gastrointestinal symptoms |
Because tislelizumab is a monoclonal antibody cleared through catabolism (breakdown by the body’s normal protein degradation processes) rather than hepatic cytochrome P450 metabolism, traditional drug-drug interactions mediated by CYP enzymes are not expected. However, the pharmacodynamic interaction with immunosuppressive agents is clinically significant and must be carefully managed. When Tevimbra is given in combination with chemotherapy, refer to the prescribing information of the chemotherapy agents for their specific drug interactions.
What Is the Correct Dosage of Tevimbra?
Tevimbra is always administered by a doctor or nurse as an intravenous infusion (drip into a vein) in a hospital or clinic under the supervision of an experienced healthcare professional. Unlike many chemotherapy drugs, Tevimbra uses a flat (fixed) dose rather than a weight-based dose, which simplifies preparation and administration.
Standard Dosing Schedules
Tevimbra 200 mg Every 3 Weeks
Dose: 200 mg administered as an intravenous infusion
Frequency: Once every 3 weeks (21-day cycles)
First infusion: Given over 60 minutes
Subsequent infusions: If the first infusion is well tolerated, subsequent infusions may be given over 30 minutes
Tevimbra 400 mg Every 6 Weeks
Dose: 400 mg administered as an intravenous infusion
Frequency: Once every 6 weeks (42-day cycles)
First infusion: Given over 120 minutes (or 90 minutes if transitioning from the 200 mg every-3-week schedule)
Second infusion: If the first infusion is well tolerated, given over 60 minutes
Subsequent infusions: If the second infusion is also well tolerated, further infusions may be given over 30 minutes
Combination with Chemotherapy
When Tevimbra is given in combination with chemotherapy, Tevimbra is administered first, followed by the chemotherapy. Refer to the prescribing information for the individual chemotherapy agents for their specific dosing schedules. Your oncologist will determine the most appropriate combination regimen based on your cancer type, overall health, and treatment goals.
Treatment Duration
Your doctor will determine how many treatment cycles you need. For metastatic cancer, treatment typically continues until disease progression, unacceptable toxicity, or for a maximum duration defined by clinical guidelines (often up to 2 years). For the neoadjuvant/adjuvant NSCLC indication, Tevimbra is given for a defined number of cycles before and after surgery.
Children and Adolescents
Tevimbra should not be used in children and adolescents under 18 years of age. The safety and efficacy of tislelizumab have not been established in this population.
Missed Dose
If you miss a scheduled appointment for your Tevimbra infusion, contact your doctor immediately to reschedule. It is very important not to miss a dose of this medicine. Your doctor will determine when you should receive your next dose and adjust the treatment schedule accordingly.
Stopping Treatment
Do not stop Tevimbra treatment without first discussing it with your doctor. Stopping treatment may cause the cancer to progress. If treatment is interrupted or discontinued due to side effects, your doctor will explain the next steps and any alternative treatment options.
Tevimbra is always prepared and administered by trained healthcare professionals in a hospital or specialized clinic. You will not self-administer this medication at home. Each infusion is given under medical supervision with appropriate monitoring for potential reactions.
What Are the Side Effects of Tevimbra?
Like all medicines, Tevimbra can cause side effects, although not everyone gets them. The side effect profile differs depending on whether Tevimbra is given alone (monotherapy) or in combination with chemotherapy. Many side effects are related to Tevimbra’s mechanism of action — by activating the immune system against cancer, it can sometimes also trigger immune attacks against healthy organs. Your medical team will monitor you closely throughout treatment.
Side Effects When Tevimbra Is Given Alone (Monotherapy)
Very Common
May affect more than 1 in 10 people
- Anemia (low red blood cells) – causing weakness, rapid heartbeat, shortness of breath
- Thrombocytopenia (low platelets) – causing easy bruising or bleeding
- Hypothyroidism (underactive thyroid) – causing fatigue, weight gain, feeling cold
- Cough
- Nausea
- Diarrhea
- Skin rash
- Itching (pruritus)
- Fatigue
- Fever (pyrexia)
- Decreased appetite
- Elevated liver enzymes (AST, ALT)
- Elevated bilirubin (which may cause yellowing of skin/eyes)
Common
May affect up to 1 in 10 people
- Pneumonia (lung infection)
- Neutropenia and lymphopenia (low white blood cells) – increasing infection risk
- Hyperthyroidism (overactive thyroid) – causing hyperactivity, sweating, weight loss
- Thyroiditis (thyroid inflammation)
- Hyperglycemia (high blood sugar)
- Hyponatremia (low sodium) – causing fatigue, confusion, muscle cramps
- Hypokalemia (low potassium) – causing muscle weakness, spasms
- Hypertension (high blood pressure)
- Dyspnea (shortness of breath)
- Pneumonitis (immune-mediated lung inflammation)
- Stomatitis (mouth sores)
- Hepatitis (immune-mediated liver inflammation)
- Joint pain (arthralgia) and muscle pain (myalgia)
- Elevated alkaline phosphatase and creatinine
- Infusion-related reactions (fever, chills, rash, itching, flushing, breathlessness)
Uncommon
May affect up to 1 in 100 people
- Adrenal insufficiency (adrenal glands not producing enough hormones)
- Hypophysitis (pituitary gland inflammation) – causing headaches, vision changes, fatigue
- Diabetes mellitus
- Uveitis (eye inflammation) – causing red, painful, swollen eyes
- Myocarditis (heart muscle inflammation) – causing chest pain, rapid heartbeat, breathlessness
- Pericarditis (inflammation of the lining around the heart)
- Pancreatitis (pancreas inflammation) – causing severe upper abdominal pain
- Colitis (colon inflammation) – causing severe diarrhea, blood in stool
- Vitiligo (skin discoloration)
- Severe skin reactions – itching, peeling, sores
- Myositis (muscle inflammation) – causing muscle pain, stiffness, weakness
- Arthritis (joint inflammation) – causing joint pain, swelling, reduced mobility
- Nephritis (kidney inflammation) – causing changes in urine output or color
Rare
May affect up to 1 in 1,000 people
- Guillain-Barré syndrome – causing tingling, weakness, and potentially paralysis starting in the legs
- Celiac disease (gluten intolerance)
- Stevens-Johnson syndrome (SJS) – serious skin reaction with rashes, blisters, peeling skin
- Non-infectious cystitis (bladder inflammation) – causing frequent, painful urination
Not Known
Frequency cannot be estimated from available data
- Hemophagocytic lymphohistiocytosis (HLH) – a condition where the immune system overproduces infection-fighting cells, causing fever, rash, swollen lymph nodes, breathing difficulties
- Exocrine pancreatic insufficiency – reduced production of digestive enzymes
- Toxic epidermal necrolysis (TEN) – severe widespread skin reaction with blistering and peeling
Additional Side Effects When Given with Chemotherapy
When Tevimbra is administered in combination with chemotherapy, the side effect profile broadens due to the additive effects of the chemotherapy agents. In addition to the side effects listed above, the following have been reported:
Very Common (Combination)
May affect more than 1 in 10 people
- Severe neutropenia and lymphopenia (very low white blood cells)
- Leukopenia (low total white blood cell count)
- Hyponatremia (low sodium)
- Hypokalemia (low potassium)
- Hyperglycemia (high blood sugar)
- Joint pain (arthralgia)
- Elevated creatinine (suggesting kidney stress)
Common (Combination)
May affect up to 1 in 10 people
- Myocarditis (heart muscle inflammation)
- Pancreatitis (pancreas inflammation)
- Colitis (colon inflammation)
- Arthritis (joint inflammation)
- Diabetes mellitus
Rare (Combination)
May affect up to 1 in 1,000 people
- Hemophagocytic lymphohistiocytosis (HLH)
- Encephalitis (brain inflammation) – causing confusion, fever, memory problems, seizures
- Guillain-Barré syndrome
- Myasthenia gravis (severe muscle weakness)
- Pericarditis (inflammation around the heart)
- Sjögren’s syndrome (autoimmune condition affecting moisture-producing glands)
Stop receiving Tevimbra and contact your doctor immediately if you develop: target-shaped or circular red patches on the trunk, with or without blisters in the center; peeling skin; sores in the mouth, throat, nose, or genitals; or flu-like symptoms followed by a painful rash. These could be signs of Stevens-Johnson syndrome or toxic epidermal necrolysis, which are medical emergencies.
If you experience any side effects, including those not listed here, tell your doctor or nurse. You can also report suspected side effects to your national pharmacovigilance authority (e.g., the EMA in Europe, the FDA MedWatch program in the United States, or the MHRA Yellow Card Scheme in the United Kingdom).
How Should Tevimbra Be Stored?
Keep this medicine out of the sight and reach of children. Do not use after the expiry date stated on the carton and vial label after EXP. The expiry date refers to the last day of that month.
- Unopened vials: Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze.
- Light protection: Keep the vial in the outer carton to protect from light.
- No preservative: Tevimbra does not contain a preservative. Chemical and physical stability of the diluted solution has been demonstrated for 10 days (240 hours) at 2–8°C. This 10-day period includes refrigerated storage, time for the medicine to reach room temperature (25°C or below), and infusion time of up to 4 hours.
- Microbiological precaution: From a microbiological standpoint, the diluted product should be used immediately after preparation.
- Do not freeze: The diluted solution must never be frozen.
- Disposal: Do not save any unused infusion solution for later use. Unused medicine and waste should be disposed of according to local regulations.
As Tevimbra is prepared and administered in a hospital or clinic, storage will be handled by your healthcare team and pharmacy. Your doctor, pharmacist, or nurse is responsible for proper storage and disposal of this medicine.
What Does Tevimbra Contain?
Active Substance
The active substance is tislelizumab. Each single-use vial contains 100 mg of tislelizumab in 10 mL of concentrate for solution for infusion, at a concentration of 10 mg/mL. Tislelizumab is a humanized IgG4 monoclonal antibody produced by recombinant DNA technology in Chinese hamster ovary (CHO) cells.
Inactive Ingredients (Excipients)
- Sodium citrate dihydrate
- Citric acid monohydrate
- L-histidine hydrochloride monohydrate
- L-histidine
- Trehalose dihydrate
- Polysorbate 20
- Water for injections
Appearance
Tevimbra concentrate for solution for infusion is a clear to slightly opalescent, colorless to pale yellow liquid. Each pack contains 1 vial. A multipack containing 2 vials (2 individual packs of 1 vial each) is also available. Before administration, the concentrate must be diluted in sodium chloride 9 mg/mL (0.9%) injection solution to a final concentration of 2 to 5 mg/mL.
Marketing Authorization Holder
Tevimbra is marketed by BeOne Medicines Ireland Limited, 10 Earlsfort Terrace, Dublin 2, D02 T380, Ireland. The manufacturing site is BeOne Medicines I GmbH, Dutch Branch, Schiphol, Netherlands.
Frequently Asked Questions About Tevimbra
Tevimbra (tislelizumab) is a PD-1 immune checkpoint inhibitor used in adults to treat several types of advanced cancer. These include non-small cell lung cancer (NSCLC) – both as treatment for metastatic disease and as neoadjuvant/adjuvant therapy around surgery – extensive-stage small cell lung cancer (ES-SCLC), gastric or gastroesophageal junction adenocarcinoma, esophageal squamous cell carcinoma, and nasopharyngeal carcinoma. It is used for cancers that have spread or cannot be surgically removed, and may be given alone or in combination with chemotherapy depending on the specific cancer type and treatment setting.
Tevimbra (tislelizumab) was specifically engineered to minimize binding to Fc-gamma receptor I (FcγRI) on macrophages. In preclinical studies, binding of anti-PD-1 antibodies to FcγRI on macrophages was associated with antibody-dependent phagocytosis – the engulfment and destruction of the very T cells the drug was meant to activate. By reducing this interaction, tislelizumab may theoretically preserve more active anti-tumor T cells. However, head-to-head clinical trials comparing tislelizumab directly with other PD-1 inhibitors are limited, and the clinical significance of this engineered difference continues to be studied.
Tevimbra is not described as a cure for cancer, but it can produce durable responses in some patients. Immune checkpoint inhibitors like tislelizumab have changed the treatment landscape for many cancers by enabling long-lasting disease control in a subset of patients. Some patients experience complete responses (no detectable cancer) that persist for years after treatment ends. However, not all patients respond to PD-1 inhibitors, and response rates vary by cancer type, PD-L1 expression, and other factors. Your oncologist will discuss realistic treatment goals based on your individual situation.
The duration of Tevimbra treatment depends on your cancer type, response to therapy, and whether you experience side effects. For metastatic cancers, treatment typically continues for as long as you benefit from it – meaning the cancer is responding or stable – and until disease progression, unacceptable toxicity, or a maximum treatment duration (commonly up to 2 years). For the neoadjuvant/adjuvant NSCLC setting, treatment is given for a defined number of cycles before and after surgery. Your oncologist will reassess your treatment at regular intervals with imaging scans and blood tests.
Report any new or worsening symptoms to your doctor promptly. Many immune-mediated side effects can be effectively managed if detected early, typically with corticosteroids and temporary interruption of Tevimbra. Carry your patient alert card at all times and show it to any healthcare professional who treats you, even for unrelated conditions, so they are aware you are receiving immunotherapy. Seek immediate medical attention for symptoms such as severe shortness of breath, chest pain, persistent high fever, severe diarrhea, yellowing of skin or eyes, severe skin reactions, or significant muscle weakness.
Live vaccines (such as MMR, varicella, BCG, and yellow fever vaccines) should be avoided during treatment with Tevimbra, as the altered immune response could lead to unpredictable reactions or vaccine-strain infections. Inactivated vaccines (such as influenza and COVID-19 vaccines) may be administered, but the immune response may be reduced, meaning the vaccines may be less effective. Discuss your vaccination needs with your oncologist, who can advise on the best timing and type of vaccines during and after treatment.
References
- European Medicines Agency (EMA). Tevimbra (tislelizumab) – Summary of Product Characteristics. Last updated 2025. Available from: EMA EPAR.
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- Lu S, Wang J, Yu Y, et al. Tislelizumab Plus Chemotherapy as First-Line Treatment for Locally Advanced or Metastatic Nonsquamous NSCLC (RATIONALE 304). J Thorac Oncol. 2021;16(9):1512–1522. doi:10.1016/j.jtho.2021.05.005.
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- Shen L, Kato K, Kim SB, et al. Tislelizumab versus chemotherapy as second-line treatment for advanced or metastatic esophageal squamous cell carcinoma (RATIONALE 302). J Clin Oncol. 2022;40(26):3065–3076. doi:10.1200/JCO.21.01926.
- Xu J, Jiang H, Pan Y, et al. Tislelizumab Plus Chemotherapy as First-line Treatment for Advanced Gastric or Gastroesophageal Junction Cancer (RATIONALE 305). JAMA. 2024;331(12):1028–1038.
- National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer. Version 3.2025.
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