Indications
Cetuximab is a cancer medicine used to treat advanced (metastatic) colorectal cancer whose tumour has a normal (wild-type) RAS gene, and squamous cell cancer of the head and neck, either together with radiotherapy or with chemotherapy.
How It Works
Cetuximab is a monoclonal antibody, a laboratory-made protein that attaches to a specific target. It binds to the epidermal growth factor receptor (EGFR) on the surface of cancer cells. This blocks the growth signals the cells receive, slowing or stopping their growth, and helps the immune system recognise and attack them.
Dosage and Administration
Cetuximab is given as a slow infusion into a vein (IV drip) by a doctor or nurse in a hospital or cancer centre, usually once a week or once every two weeks. The dose is calculated by the specialist from your body surface area, as prescribed. Before each infusion you will receive medicines such as an antihistamine and a corticosteroid to reduce the risk of an infusion reaction, and you will be watched closely during and after the infusion.
Interactions
- Chemotherapy such as Fluorouracil or platinum medicines: can increase diarrhoea, low white blood cell counts and skin reactions.
- Radiotherapy: skin reactions in the treated area may be stronger.
- Tell your cancer team about all medicines, vitamins and herbal products you use.
Contraindications
- Previous severe allergic reaction to Cetuximab.
- Colorectal cancer with a mutated RAS gene, or where RAS status is unknown, when combined with Oxaliplatin-based chemotherapy.
Side Effects
Very common side effects include an acne-like rash, dry or cracked skin, itching, nail fold infections, tiredness, diarrhoea, mouth sores and low magnesium levels in the blood. Infusion reactions with fever, chills, dizziness or breathing difficulty can occur, most often with the first dose. Eye irritation and hair changes are also reported.
Get urgent medical help if you have sudden breathing difficulty, swelling of the face or throat, chest pain, fainting, severe or blistering skin reactions, a new or worsening cough with breathlessness, or severe diarrhoea with dehydration.
Pregnancy and Lactation
Cetuximab may harm an unborn baby and is used in pregnancy only if the specialist judges it essential. Women who could become pregnant should use reliable contraception during treatment and for at least two months after the last dose. Do not breastfeed during treatment and for two months after the last dose.
Precautions and Warnings
- Avoid strong sunlight and use sunscreen, as sun can worsen skin reactions.
- Blood levels of magnesium, calcium and potassium are checked regularly.
- People with heart or lung disease need extra monitoring, especially when receiving radiotherapy at the same time.
- Report any eye pain, redness or blurred vision.
Overdose
As the dose is given by health professionals, overdose is unlikely. If it happens, the medical team will watch for and treat side effects.
Therapeutic Class
Antineoplastic monoclonal antibody (EGFR inhibitor).
Storage
Store in a refrigerator at 2 to 8°C, do not freeze. Hospital medicine: keep as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.