Kepivance (palifermin) is a truncated human KGF produced by recombinant DNA technology in E coli. Kepivance is a water soluble, 140 amino acid protein with a molecular weight of 16.3 kilodaltons. It differs from endogenous human KGF in that the first 23 N terminal amino acids have been deleted to improve protein stability.
Kepivance is supplied as a sterile, white, preservative-free, lyophilized powder for intravenous injection after reconstitution with 1.2 mL of Sterile Water for Injection, USP. Reconstitution yields a clear, colorless solution of Kepivance (5 mg/mL) with a pH of 6.5. Each single use vial of Kepivance contains palifermin (6.25 mg),with L histidine (1.94 mg), mannitol (50 mg), polysorbate 20 (0.13 mg or 0.01% w/v), and sucrose (25 mg).
Kepivance is a mucocutaneous epithelial human growth factor indicated to decrease the incidence and duration of severe oral mucositis in patients with hematologic malignancies receiving myelotoxic therapy requiring hematopoietic stem cell support. Kepivance is indicated as supportive care for preparative regimens predicted to result in ≥ WHO Grade 3 mucositis in the majority of patients.
Limitations of Use
The safety and efficacy of Kepivance have not been established in patients with non-hematologic malignancies [see Warnings and Precautions (5.1
Kepivance is not recommended for use with melphalan 200 mg/m2 as a conditioning regimen [See Clinical Studies].
Published Studies Related to Kepivance (Palifermin)
Palifermin reduces severe mucositis in definitive chemoradiotherapy of locally advanced head and neck cancer: a randomized, placebo-controlled study. [2011.07.10]
PURPOSE: Oral mucositis (OM) is a debilitating toxicity of chemoradiotherapy for head and neck cancer (HNC). This randomized, placebo-controlled, double-blind study evaluated the efficacy and safety of palifermin to reduce OM associated with definitive chemoradiotherapy for locally advanced HNC... CONCLUSION: Although palifermin reduced severe functional OM, its role in the management of locally advanced HNC during chemoradiotherapy remains to be elucidated.
Palifermin decreases severe oral mucositis of patients undergoing postoperative radiochemotherapy for head and neck cancer: a randomized, placebo-controlled trial. [2011.07.10]
PURPOSE: Radiochemotherapy of head and neck cancer causes severe mucositis in most patients. We investigated whether palifermin reduces this debilitating sequela... CONCLUSION: Palifermin reduced the occurrence of severe oral mucositis in patients with head and neck cancer undergoing postoperative radiochemotherapy. Additional clinical exploration of palifermin with postoperative radiochemotherapy would be useful.
Single-dose palifermin prevents severe oral mucositis during multicycle chemotherapy in patients with cancer: a randomized trial. [2010.09.21]
BACKGROUND: Mucositis can be a serious complication of cancer treatment. Palifermin reduces mucositis when given in multiple doses to patients undergoing hematopoietic stem-cell transplantation. OBJECTIVE: To evaluate the efficacy of palifermin given as a single dose before each cycle in patients receiving multicycle chemotherapy... CONCLUSION: A single dose of palifermin before each cycle reduced the incidence and severity of mucositis. The drug was generally well tolerated, but most patients experienced thickening of oral mucosa. Further investigation is needed to determine whether palifermin use will facilitate greater adherence to chemotherapy regimens by reducing mucositis.
Gut protection by palifermin during autologous haematopoietic SCT. [2009.05]
Conditioning therapy in connection with haematopoietic SCT (HSCT) induces a disruption of the intestinal barrier function facilitating the permeation of bacteria and endotoxin through the bowel wall with subsequent increased risk of septicaemia and a worsening of GVHD in the allogeneic setting.
Long-term follow-up of a phase I/II randomized, placebo-controlled trial of palifermin to prevent graft-versus-host disease (GVHD) after related donor allogeneic hematopoietic cell transplantation (HCT). [2008.09]
We previously conducted a randomized, double-blind, placebo-controlled study conducted from 2000 to 2003 of palifermin, a recombinant human keratinocyte growth factor, dosed from 240 microg/kg to 720 microg/kg, in 100 allogeneic hematopoietic stem cell transplantation (HCT) recipients... We conclude that the benefits of palifermin appear primarily to be limited to ameliorating mucotoxicity when given to allogeneic HCT recipients.
Clinical Trials Related to Kepivance (Palifermin)
Melphalan and Palifermin in Treating Patients Undergoing An Autologous Peripheral Stem Cell Transplant for Stage II or III Multiple Myeloma [Completed]
RATIONALE: Drugs used in chemotherapy, such as melphalan, work in different ways to stop the
growth of tumor cells, either by killing the cells or by stopping them from dividing.
Keratinocyte growth factors, such as palifermin, may help prevent symptoms of mucositis, or
mouth sores, in patients receiving melphalan before a peripheral stem cell transplant for
PURPOSE: This phase I trial is studying the side effects and best dose of melphalan when
given together with palifermin in treating patients undergoing an autologous peripheral stem
cell transplant for stage II or stage III multiple myeloma.
Palifermin DDI (Drug Drug Interaction) [Completed]
The purpose of this study is to determine if Paliferim interacts with Heparin.
A Study of Palifermin for the Reduction of Oral Mucositis in Subjects With Multiple Myeloma [Completed]
The purpose of this study was to evaluate the efficacy and effect of palifermin on the
incidence of oral mucositis in subjects with multiple myeloma receiving Melphalan followed
by autologous peripheral blood stem cell transplantation. Amendment 01 (April 07) introduced
three cataract assessments to be carried out at Screening, Month 6 and Month 12 in response
to FDA and EMEA follow up measures.
Palifermin for the Reduction of Oral Mucositis in Patients With Locally Advanced Head and Neck Cancer [Active, not recruiting]
The purpose of this research study is to test the safety and effectiveness of palifermin to
determine if weekly doses can be safely administered to reduce the incidence (occurrence
of), duration (length of time) and severity (amount of pain) of oral mucositis (painful
sores in the mouth). Mucositis is a common side effect for patients receiving chemotherapy
(cancer-killing drug) and radiotherapy (cancer-killing x-rays) for the treatment of head and
neck cancer (HNC).
Palifermin After Haploidentical PBSCT [Withdrawn]
This is a double blind, placebo controlled clinical trial, where patients with an advanced
form of blood cancer are treated with haploidentical allogeneic peripheral blood progenitor
cell (PBPC) transplant after which they are randomised to receive either placebo or a
keratinocyte growth factor (Palifermin or Kepivance®).
The function of Kepivance® is to stimulate the growth of epithelial cells. This drug has
also been suggested to have an ability to help improve the reconstitution, or development,
of the immune system after the transplantation.
The hypothesis is that the patients T-cell dependent humoral immune response to recall
antigen (PrevenarTM) will be higher in in palifermin treated patients than in the placebo
Page last updated: 2011-12-09