Temsirolimus is used to treat kidney (renal) cancer that has spread and previously treated mantle cell lymphoma.
How temsirolimus works
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Temsirolimus is a type of treatment called an mTOR inhibitor, also known as a cancer growth inhibitor. mTOR is a protein inside cells that makes them divide and grow, and it is often overactive in cancer cells.
Temsirolimus works by blocking (inhibiting) the mTOR protein, which may help to stop the cancer growing or slow down its growth.
Temsirolimus can also stop the cancer cells from making new blood vessels. This reduces their supply of oxygen and nutrients, so that the tumour shrinks or stops growing.
When temsirolimus is given
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Temsirolimus can be used to treat people with some types of kidney cancer that has spread (advanced cancer). It may also be used to treat people with mantle cell lymphoma that has come back after chemotherapy or that hasn't responded to chemotherapy.
The National Institute for Health and Care Excellence (NICE) gives advice on which new drugs or treatments should be available on the NHS in England and Wales. The Scottish Medicines Consortium (SMC) makes recommendations on the use of new drugs within the NHS in Scotland. NICE and the SMC do not recommend the use of temsirolimus for kidney cancer or for mantle cell lymphoma. Northern Ireland endorses NICE guidance for temsirolimus.
As a result, temsirolimus may not be widely available on the NHS, although you may be given it as part of a clinical trial.
If you live in England, temsirolimus may be available if you have advanced kidney cancer, funded via the Cancer Drugs Fund.
Speak to your doctor to see if temsirolimus is recommended for your type of cancer.
How temsirolimus is given
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Temsirolimus is given as a drip into a vein (intravenous infusion). Each infusion takes 30-60 minutes. It is usually given once a week. The number of doses you have will depend on how well it is working and on how any side effects affect you. Talk to your doctor or specialist nurse about how many treatments you will have.
Possible side effects of temsirolimus
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Each person’s reaction to their treatment is different. Some people have very few side effects, while others may have more. Below are the most common side effects, but we don’t explain all the less common ones that are unlikely to affect you.
If you notice any effects that aren't listed here, tell your doctor or specialist nurse. Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice any time of day or night. Save these numbers in your phone or keep them somewhere safe.
Side effects of temsirolimus fall into two groups:
side effects that may occur during the infusion or for up to about 24 hours afterwards (infusion-related reactions)
side effects that may occur days or weeks later.
Infusion-related reactions to temsirolimus
If reactions occur, they are usually mild, but very occasionally they can be more severe. Reactions are most likely to happen with the first or second infusion, although they may occur with later infusions. If you have a reaction, this can usually be treated by stopping the drip until you feel better.
You'll be given an antihistamine drug before the infusion to reduce the risk of a reaction. If you do have one, the infusion can be stopped and restarted once you feel better.
You'll be monitored closely during the infusion, but tell your nurse or doctor if you feel unwell or have any of the following symptoms:
flu-like symptoms such as feeling flushed, having a fever, chills, or dizziness
red, warm and itchy bumps on the skin (like nettle rash)
a feeling of swelling in the lips, tongue or throat
breathlessness, wheezing, a cough or sudden difficulty in breathing
pain in your back or stomach
a tight chest or chest pain.
Sometimes an infusion-related reaction can happen a few hours after treatment. If you develop these symptoms or feel unwell after you get home, contact the hospital straight away for advice.
Other side effects of temsirolimus
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Risk of infection (neutropenia)
Temsirolimus can reduce the number of white blood cells in your blood. This will make you more likely to get an infection. When your white cells are low, this is called neutropenia.
Contact the hospital straight away on the contact number you’ve been given if:
your temperature goes over 37.5°C (99.5F) or over 38°C (100.4F), depending on the advice given by the hospital staff
you suddenly feel unwell , even with a normal temperature
you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
Your white cells usually increase steadily and return to normal before your next treatment. You will have a blood test before having more chemotherapy. If your white blood cells are still low, your doctor may delay your treatment for a short time.
Anaemia (low number of red blood cells)
Temsirolimus can reduce the number of red blood cells, which carry oxygen around the body. A low red cell count is called anaemia. This may make you feel tired and breathless. Tell your doctor or nurse if you have these symptoms. If the number of red blood cells becomes too low, you may need to have a drip to give you extra red blood cells (blood transfusion).
Bruising and bleeding
Temsirolimus can reduce the number of platelets in your blood. Platelets are cells which help the blood to clot. Tell your doctor if you have bruising or bleeding you can’t explain. This includes nose bleeds, bleeding gums, blood spots or rashes on the skin. If your platelet count is very low, you may have a drip to give you extra platelets (platelet transfusion).
You may feel tired during and after your treatment. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with taking some gentle exercise (such as short walks), which will help. If tiredness is making you feel sleepy, don’t drive or operate machinery.
Your skin may become dry and itchy. You may also notice a rash or redness. This is usually mild. Tell your doctor or nurse if you have any of these symptoms. They can prescribe creams and drugs to help.
Your mouth may become sore or dry, or you may get ulcers during this treatment. Look after your mouth by gently cleaning your teeth after meals with a soft toothbrush and drinking plenty of fluids.
Tell your nurse or doctor if you have any of these problems: they can prescribe mouthwashes and medicine to prevent or clear mouth infections.
Loss of appetite
You may lose your appetite during your treatment. Try to eat small meals regularly. If your appetite doesn’t improve after a few days, let your doctor or nurse know. They can arrange for you to see a dietician who can give you advice. You may be given food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can buy them from chemists.
Feeling or being sick
If you feel sick, this can be controlled by taking anti-sickness (anti-emetic) drugs that your doctor can prescribe for you. Tell your doctor if the sickness doesn’t improve so they can prescribe other anti-sickness drugs which may work better for you.
You may have frequent or loose bowel movements. This can usually be controlled by taking anti-diarrhoea drugs. Your doctor can prescribe these for you. You should tell your doctor if it’s severe or continues. It's important to drink plenty of fluids if you have diarrhoea, around 2 litres (4 pints) per day.
Some people develop swelling around the eyes, ankles or other areas of their body because of a build-up of fluid. This isn’t harmful, but it can be upsetting and uncomfortable. Diuretics (drugs that make you pass more urine) can help get rid of some of the fluid, but it often settles down by itself. Let your doctor know if you put on a lot of weight very quickly. This can be a sign that you’re retaining fluid.
Raised blood sugar
Temsirolimus may cause a temporary increase in the level of sugar in your blood. Your blood sugar levels will be checked by regular blood tests. Signs of a raised blood sugar level are feeling thirsty, needing to pass urine more often and feeling hungry. If you get any of these symptoms let your doctor or nurse know.
If you are diabetic you may need to check your blood sugars more regularly. Talk to your doctor or nurse about how to manage this. You may have to adjust your insulin or tablet dose.
Less common side effects
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Cancer increases the chance of a blood clot (thrombosis) and temsirolimus can add to this. A clot can cause symptoms such as pain, redness and swelling in a leg, breathlessness and chest pain. Contact your doctor straight away if you have any of these symptoms. A blood clot is serious but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Breathlessness and cough
You may notice you are out of breath more than normal or develop a cough. This is more likely if you already have lung problems. Let your doctor know if you this happens.
Abdominal (tummy) pain
Some people have pain or discomfort in their tummy during treatment with temsirolimus. Let your doctor know if this happens to you. It can usually be controlled with painkillers.
Very rarely, temsirolimus can cause a hole (perforation) in the small bowel. Contact your doctor immediately if you have severe pain in the tummy or signs of bleeding such as bleeding from the back passage, black stools or vomiting up blood (or vomit that looks like coffee grounds).
Changes to your blood cholesterol
The level of cholesterol in your blood may rise. Your doctor will take blood samples regularly to check this.
Muscle and joint pain
You may notice that you have back pain, sore muscles and joints. Let your doctor know if you get these side effects, as they can prescribe painkillers.
Temsirolimus can cause sleeplessness (insomnia) in some people. If you are finding it difficult to sleep, talk to your doctor or specialist nurse.
Problems with wound healing
Wounds may take longer to heal during treatment with temsirolimus. If you have any surgery planned, you may need to stop having temsirolimus before the operation and not start it again for a few weeks afterwards. Talk to your doctor if you have surgery planned.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they are not mentioned above.
Additional information about temsirolimus
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Some medicines can interact with temsirolimus. This includes medicines you can buy in a shop or chemist. Tell your doctor about any medicines you're taking, including ones you can buy for yourself, complementary therapies, vitamins and herbal drugs. You should also avoid eating grapefruit or drinking grapefruit juice while having temsirolimus.
Doctors don’t yet know how temsirolimus may affect your fertility. If you are worried about this, talk to your doctor before treatment starts.
Your doctor will advise you not to become pregnant or father a child during treatment. You can talk to your doctor or nurse about this.
Women are advised not to breastfeed during treatment and for a few months afterwards. This is in case there is any trace of the drug in their breast milk.
You should avoid having live vaccines during treatment and for at least 12 months afterwards. Live vaccines include BCG, yellow fever, measles, mumps, rubella, liquid typhoid, liquid poliomyelitis and MMR.
Medical or dental treatment
If you need to go into hospital for a reason not related to your cancer, always tell the doctors and nurses looking after you that you are having treatment with temsirolimus. You should tell them the name of your cancer specialist so they can ask them for advice.
Always tell your dentist you are taking temsirolimus.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a healthcare professional.
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