Kepivance

Kepivance is the brand name for palifermin, a recombinant human keratinocyte growth factor-1 (rhKGF-1). It is used as a supportive therapy in cancer treatment to help protect and promote healing of the oral mucosa. Palifermin acts on epithelial cells by binding to fibroblast growth factor receptor 2b (FGFR2b), stimulating proliferation and differentiation of mucosal tissues, particularly the oral mucosa.

Indications for Kepivance include the prevention of severe oral mucositis in patients with hematologic malignancies undergoing hematopoietic stem cell transplantation after conditioning regimens that include total body irradiation or high-dose chemotherapy with alkylating agents. It is administered as part of the transplantation protocol to reduce the incidence and duration of severe mucositis, which can affect nutrition, infection risk, and overall recovery.

Administration and dosing are by subcutaneous injection. The typical regimen is 60 micrograms per kilogram per day for three consecutive days prior to conditioning therapy and for three consecutive days after conditioning, with the exact schedule tailored to institutional protocols and patient needs.

Common adverse effects include rash, erythema, edema, pruritus, and alterations in taste, as well as mucosal reactions. Other possible effects are fever, dehydration, and oral or tongue swelling. Palifermin is generally well tolerated, but as with any biologic, patients are monitored for reactions and interactions with concurrent therapies.

Regulatory status: Kepivance was approved by the U.S. Food and Drug Administration in 2004 for mucositis prevention in adults undergoing HSCT and has been used in various HSCT settings since.