Care During Chemotherapy and Beyond
Generic Name: Cetuximab
Other Name: C225
Erbitux is a targeted therapy. It is classified as a "monoclonal antibody"
and "signal transduction inhibitor" by binding to epidermal growth factor receptors
(EGFR). (For more detail, see "How Erbitux Works" section below.)
What Erbitux Is Used For:
- Erbitux is used to treat metastatic colorectal cancer (cancer spread beyond
the colon or rectum) that over-expresses the epidermal growth factor receptor (EGFR).
- Approved for the treatment of squamous cell carcinoma of the head and neck.
Note: If a drug has been approved for one use, physicians may elect to use
this same drug for other problems if they believe it may be helpful.
How Erbitux Is Given:
- By intravenous (IV) infusion.
- The amount of cetuxumab that you will receive depends on many factors, including
your height and weight, your general health or other health problems, and the type
of cancer or condition being treated. Your doctor will determine your dose
Erbitux Side Effects:
Important things to remember about the side effects of cetuxumab include:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of Erbitux.
The following side effects are common (occurring in greater than 30%) for patients
These side effects are less common side effects (occurring in about 10-29%) of patients
- Nausea and vomiting
- Poor appetite
- Abdominal pain
- Nail disorder - inflammation of the skin surrounding a fingernail or toenail
- Mouth sores
- Difficulty sleeping
- Low red blood cell count (Anemia)
Infusion reactions (chills, fever, shortness of breath) have been experienced with
this infusion - rarely, this reaction can be severe with difficulty breathing, itching,
low blood pressure. Pre-medication is given prior to infusion as a precaution.
Not all side effects are listed above. Some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your
health care provider if you experience any unusual symptoms.
When To Contact Your Doctor or Health Care Provider:
Seek emergency help immediately and notify your health care provider, it you experience
the following symptoms:
- Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling
of facial features, hives (possible allergic reaction).
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the following:
- Nausea (interferes with ability to eat and unrelieved with prescribed Erbitux).
- Vomiting (vomiting more than 4-5 times in a 24 hour period).
- Diarrhea (4-6 episodes in a 24-hour period).
- Extreme fatigue (unable to carry on self-care activities).
- Mouth sores (painful redness, swelling or ulcers).
- Constipation unrelieved by laxative use.
- Swelling of the feet or ankles. Sudden weight gain.
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst,
dry mouth, dark and decrease amount of urine, or dizziness.
Always inform your health care provider if you experience any unusual symptoms.
- Before starting Erbitux treatment, make sure you tell your doctor about any other
medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.). Do not take aspirin, or products containing
aspirin unless your doctor specifically permits this.
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking Erbitux.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category C (use in pregnancy only when
benefit to the mother outweighs risk to the fetus).
- For both men and women: Do not conceive a child (get pregnant) while taking Erbitux.
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking Erbitux and for 60 days following the last dose.
Erbitux Self Care Tips:
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- Wash your hands often.
- You may be at risk of infection report fever or any other signs of infection immediately
to your health care provider.
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed
with 8 ounces of water.
- Erbitux causes little nausea. But if you should experience nausea, take anti-nausea
medications as prescribed by your doctor, and eat small frequent meals. Sucking
on lozenges and chewing gum may also help.
- Keep your bowels moving. Your health care provider may prescribe a stool softener
to help prevent constipation that may be caused by Erbitux.
- An acne-like rash is a common side effect of Erbitux. If you are experiencing
this side effect make sure your health care professional is aware, so they can assess
the severity and offer suggestions for management.
- Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
- Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or
generalized aches and pains. However, be sure to talk with your doctor before
Monitoring and Testing While Taking Erbitux:
You will be checked regularly by your health care professional while you are taking
Erbitux, to monitor side effects and check your response to therapy. Periodic
blood work to monitor your complete blood count (CBC), electrolyte levels as
well as the function of other organs (such as your kidneys and liver) will also
be ordered by your doctor.
How Erbitux Works:
About Targeted Therapy
Targeted therapy is the result of about 100 years of research dedicated to understanding
the differences between cancer cells and normal cells. To date, cancer treatment
has focused primarily on killing rapidly dividing cells because one feature of cancer
cells is that they divide rapidly. Unfortunately, some of our normal cells divide
rapidly too, causing multiple side effects.
Targeted therapy is about identifying other features of cancer cells. Scientists
look for specific differences in the cancer cells and the normal cells. This information
is used to create a targeted therapy to attack the cancer cells without damaging
the normal cells, thus leading to fewer side effects. Each type of targeted therapy
works a little bit differently but all interfere with the ability of the cancer
cell to grow, divide, repair and/or communicate with other cells. Modern targeted
therapy types include the use of monoclonal antibodies and anti-angiogenesis drugs,
both of which are described in greater depth here.
The different types of targeted therapies are defined in three broad categories.
Some targeted therapies focus on the internal components and function of the cancer
cell. The targeted therapies use small molecules that can get into the cell and
disrupt the function of the cells, causing them to die. There are several types
of targeted therapy that focus on the inner parts of the cells. Other targeted therapies
target receptors that are on the outside of the cell. Therapies that target receptors
are also known as monoclonal antibodies. Anti-angiogenesis drugs target the blood
vessels that supply oxygen to the cells, ultimately causing the cells to starve.
Researchers agree that targeted therapies are not a replacement for traditional
therapies. Targeted therapies involve production of components such as monoclonal
antibodies or anti-angiogenesis drugs may best be used in the short term, combination
with traditional therapies. More research is needed to identify which cancers may
be best treated with targeted therapies such as monoclonal antibodies or anti-angiogenesis
drugs and to identify additional targets for more types of cancer.
Using Monoclonal Antibodies as Targeted Therapy
Monoclonal antibodies are a relatively new type of "targeted" cancer therapy. Antibodies
are part of the immune system. Normally, the body creates antibodies in response
to an antigen (such as a protein in a germ) entering the body. The antibodies attach
to the antigen in order to mark the antigen for destruction by the body's immune
system. In the laboratory, scientists analyze specific antigens on the surface of
cancer cells (target) to determine a protein to match the antigen. Then, using protein
from animals and humans, scientists work to create a special antibody that will
attach to the target antigen. An antibody will attach to a matching antigen like
a key fits a lock. This technology allows treatment to target specific cells, causing
less toxicity to healthy cells. Monoclonal antibody therapy can be done only for
cancers in which antigens (and the respective antibodies) have been identified.
Erbitux is a targeted therapy that targets and binds to the epidermal growth factor
receptors (EGFR) on the surface of the cell. EGFR is found on the surface of many
normal and cancer cells. By binding to these receptors, Erbitux blocks an
important pathway that promotes cell division this results in inhibition of cell
growth and apoptosis (cell suicide).
Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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