Temsirolimus (Torisel)

Temsirolimus is pronounced tem-sir-oh-li-mus. It is also known by its brand name Torisel. Temsirolimus is a type of drug treatment called an mTOR inhibitor. It blocks the effects of a particular protein called mTOR that is often over active in cancer cells and makes the cells divide and grow. 

Temsirolimus also stops the cancer from making blood vessels, which the cells need to be able to grow. It is called an anti angiogenesis treatment. So temsirolimus helps to stop the cancer growing or may slow the growth.

Temsirolimus is a treatment for advanced kidney cancer and for advanced mantle cell lymphoma.

You can have temsirolimus through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drug directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.

You have temsirolimus once a week and it takes between 30 and 60 minutes. You have an anti histamine drug before each dose. You usually carry on having temsirolimus for as long as it works. If you take any other medicines you need to tell your doctor before starting temsirolimus treatment.

The side effects associated with temsirolimus are listed below. You can click on the links to find information about dealing with each side effect. Or go to the cancer drug side effects section for general information.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
• Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)

Some of these side effects can be life threatening, particularly infections. You should contact your treatment centre if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Skin changes – about 4 out of 10 people (40%) have a rash or red, dry, itchy skin. This can become severe in 1 in 20 people (5%). Tell your doctor or nurse if you get a rash
• Feeling or being sick happens in about 4 out of every 10 people (40%) but is usually well controlled with anti sickness drugs
• Shortness of breath occurs in 3 out of 10 people (30%)
• Poor appetite happens in about 1 in 3 people (more than 30%)
• Diarrhoea affects 1 out of 4 people (25%) – drink plenty of fluid and tell your doctor or nurse if it becomes severe, or continues for more than 3 days
• Abdominal pain in 1 in 5 people (20%)
• A sore mouth or mouth ulcers occurs in about 3 out of 10 people (30%)
• A rise in blood sugar levels happens in 1 in 4 people (25%) – tell your doctor or nurse if you feel thirsty and need to pass urine often. If you have diabetes you should check your blood sugar levels more regularly than usual and may need to increase the amount of tablets or insulin you take
• Low levels of potassium in your blood (hypokalaemia) – you will have blood tests to check the levels of potassium and other minerals, such as calcium and phosphate
• Fluid retention happens in just over a third of people (35%) and is usually mild but can be uncomfortable
• Pain in the joints, muscles and back occurs in about 1 in 5 people (20%)
• Difficulty in sleeping occurs in just over 1 in 10 people (10%)
• Feeling weak, a high temperature and chills
• Cholesterol levels in your blood may go up – you will have regular blood tests to check your cholesterol levels
• Loss of fertility – we don’t know exactly how this drug may affect fertility so do talk to your doctor before starting treatment if having a baby is important to you
• We don’t know whether temsirolimus can harm a developing baby – so do talk to your doctor or nurse about contraception before having treatment if there is any chance you or your partner could become pregnant

Between 1 and 10 in every 100 people have one or more of these.

• Feeling anxious
• Taste changes
• An allergic reaction – causing chills, a high temperature and possibly an itchy rash, feeling sick, breathlessness, wheezing, a headache, flushes and faintness
• Numbness and tingling
• Sore eyes and conjunctivitis
• Blood clots – let your doctor or nurse know immediately if you have any pain, redness or swelling in an area that feels warm to the touch
• A mild effect on the kidneys, which is unlikely cause any symptoms and will almost certainly go back to normal after the treatment finishes – you will have regular blood tests to check how well your kidneys are working
• Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when treatment is finished, but you will have regular blood tests to check how well your liver is working
• Raised blood pressure – if your blood pressure goes up you may need to take tablets to control it

A few people have a split in the wall of the bowel (bowel perforation). This is extremely rare but is a serious side effect if it happens.

You will not get all these side effects and those that you have may be mild. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on

• How many times you've had a drug before
• Your general health
• How much of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. Your nurse will give you a contact number. You can ring them if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.