Erbitux (cetuximab)

How does it work?

Erbitux infusion contains the active ingredient cetuximab, which is a type of medicine called a humanised monoclonal antibody. It is used to treat head and neck cancer, and cancer of the large intestine and rectum (colorectal cancer) that has spread to other parts of the body.

Many cancer cells have structures called epidermal growth factor receptors (EGFRs) on their surfaces. These receptors allow a protein called epidermal growth factor (EGF) to attach to the cells. When the epidermal growth factor attaches to the receptor, it triggers chemical processes inside the cancer cells that make the cells grow, multiply and spread.

Cetuximab acts by binding to the EGFR. It works in a similar way to the natural antibodies produced by our immune system. Our natural antibodies recognise foreign invaders and bind to them, helping our immune systems to attack them and protect us from infections. Monoclonal antibodies like cetuximab are made in laboratories and are designed to attack particular proteins in a similar way.

Cetuximab specifically recognises and binds to the EGFR protein on the surface of the cancer cells. This blocks the receptor, stopping growth factors from attaching to it and stimulating the cells to grow and multiply. It also triggers the immune system to attack the cancerous cells.

Your doctor may do various tests to check the level of EGFR on your cancer cells, as this can predict if your cancer is likely to respond to the treatment.

Cetuximab is given to treat colorectal cancer that has spread to other parts of the body and has not responded to treatment with a chemotherapy medicine called irinotecan. It is given in combination with the irinotecan.

Cetuximab is given in combination with radiation therapy to treat head and neck cancer.

Cetuximab is given as a drip into a vein (intravenous infusion) once a week. The first dose is administered over two hours. If this is well tolerated, further doses may be given over 60 minutes. Some people can have an allergic reaction to the medicine (see warning below), so to reduce the chance of this you will usually be given an antihistamine before the drip to help prevent a reaction.

What is it used for?

Cancer of the large bowel (colon) and rectum (colorectal cancer) that has spread to other areas of the body.

Locally advanced head and neck cancer.

Warning!

You may experience infusion-related reactions during treatment with this medicine. These are usually mild to moderate but can be more severe. Symptoms may include shortness of breath, fever, chills, nausea, vomiting, headache, dizziness, hoarseness, difficulty breathing or speaking, low blood pressure or loss of consciousness. Reactions usually occur during the first infusion or up to an hour after it has finished, but can also occur after several hours or after subsequent infusions. You will be monitored closely during your infusion and for about an hour afterwards, but it is very important to tell your nurse or doctor if you get these or any other symptoms either during or after each treatment.

The most common side effects associated with this medicine are skin reactions, usually beginning in the first three weeks of treatment. These may include an acne-like rash, itching and dry or scaly skin. If you have any skin changes, let your doctor know straight away. If you have very severe skin problems the length of time between your treatments may need to be extended or the dose may be lowered.

If you feel wheezy or short of breath while having treatment with this medicine, you should let your doctor know.

This medicine may potentially be harmful to an unborn baby. For this reason, women receiving this medicine should use an effective method of contraception to prevent pregnancy during treatment and possibly for a few months after treatment is finished. You should inform your doctor immediately if you get pregnant.

It is recommended that you have regular blood tests to monitor the levels of electrolytes (salts such as magnesium, potassium and calcium) in your blood while you are having treatment with this medicine.

The manufacturer has not studied this medicine in children, or in people with kidney or liver problems, or low white blood cell, red blood cell or platelet counts.

Use with caution in

Elderly people

Heart or lung disorders.

Not to be used in

Allergy to cetuximab

Breastfeeding.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine has not been studied in pregnant women, but it could be harmful to a developing foetus. It should not be used during pregnancy unless considered essential by your doctor and only if the potential benefits to the mother outweigh the possible risk to the foetus. Women who could get pregnant should use an effective method of contraception to prevent pregnancy while having treatment with this medicine and possibly for a few months after the treatment is finished. Seek medical advice from your doctor. Inform your doctor immediately if you get pregnant at any point during treatment.

It is not known if this medicine passes into breast milk. However, as it could harm the development of the infant if it does pass into breast milk; mothers should not breastfeed during treatment with this medicine, or for at least two months after the last dose. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Skin reactions such as rash, itching, dry or scaly skin (see warning above)

Increased hair growth

Nail disorders

Increased susceptibility to skin infections

Infusion-related reactions, such as fever, chills, nausea, vomiting, headache, dizziness, or shortness of breath (see warning above)

Sore mouth

Shortness of breath

Change in liver function

Conjunctivitis

Decreased level of magnesium in the blood

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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