Cetuximabinduced hypomagnesaemia is a concern in 50% of patients with normal renal function, including 15% of chronic kidney disease. May 15, 20 prevention of acneiform rash caused by egfr inhibitors includes topical corticosteroids hydrocortisone 2. What i mean by, it probably evens out is that if you forego the erbitux your doses of the other two would probably be higher and if you went with the three they would adjust to the lower side of dosing. Erbitux cetuximab 400 mgm2 initial iv loading dose over 120 min, followed by weekly doses of 250 mgm2 iv over 60 min until disease progression or unacceptable toxicity. Sep 21, 2016 cetuximab, an antiepidermal growth factor receptor chimeric mousehuman immunoglobulin 1 monoclonal antibody against the epidermal growth factor merck, darmstadt, germany, has been approved as a treatment for advanced head and neck cancer in combination with radiation therapy. Serious infusion reactions occurred with the administration of erbitux in approximately 3% of patients. Here, we report a 68yearold metastatic osteosarcoma patient with impaired renal function due to prior chemotherapy, who was treated on compassionate use basis with 400 mgm2 cetuximab. Cetuximab is available as erbitux intravenous solution. It is now wellestablished that biomarker analysis is critical to patient selection for therapy with an egfr inhibitor. Serious infusion reactions occurred with the administration of erbitux in approximately 3% of patients in clinical trials, with fatal outcome reported in less than 1 in. What should i discuss with my healthcare provider before i receive cetuximab erbitux. Severe infusion reactionsoccurred with the administration of 6 erbitux in approximately. Qt prolongation was observed in patients treated with certain egfr inhibitors. Cetuximab side effects, dosage, interactions drugs everyday health search.
The recommended initial dose is 400 mgm 2 administered one week prior to initiating a course of radiation therapy or on the first day of platinumbased therapy and fluorouracil as a 120minute intravenous infusion. In combination with platinumbased chemotherapy and fluorouracil for the initial treatment of patients with a certain type of head and neck cancer whose tumor has returned. The high dose of cetuximab did not elicit any noticeable changes in. What are the possible side effects of cetuximab erbitux. Find patient medical information for erbitux intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings.
Biweekly cetuximab and irinotecan in advanced colorectal. Wednesday, april 1 healthday news people with advanced colorectal cancer were modestly helped by the drug erbitux, as long as they didnt have a particular. Cetuximab pharmacokinetics in endstage kidney disease. The first time you receive cetuximab, it will be infused over a period of 2 hours, then the following doses will be infused over an. As the field moves forward so also do the therapeutic opportunities, and pitfalls.
Dec 11, 2019 age, sex, race, hepatic and renal function had no clinically significant effect on the pharmacokinetics of cetuximab. May 08, 2019 what are the possible side effects of cetuximab erbitux. This website uses cookies to give you the best, most relevant experience. Erbitux dosing for head and neck cancer the standard dosage of erbitux for the treatment of squamous cell cancer of the head and neck is based on body surface area, which is normally calculated using height and weight. You can change which cookies are set at any time and find out more about them in our cookie policy.
The information on dosage adjustments in renal impairment given in this book is based on. Uclh dosage adjustment for cytotoxics in renal impairment version 3 updated january2009 page 2 of 24 dosage adjustment for cytotoxics in renal impairment this table is a guide only. Multiple dosage regimens of irinotecan have been studied in combination with cetuximab, including irinotecan 180 mgm2 iv once every 3 weeks. Maintenance chemo like erbitux cancer survivors network. Drug brand name, regimen, dose, amount needed, cost per. With folfiri combination chemotherapy as firstline therapy.
Cetuximab erbitux medical clinical policy bulletins aetna. Cetuximab can be safely used in patients with renal impairment. Inauen et al reported a case where cetuximab was well tolerated with. My chemo doc is researching putting me on a maintenance chemo like erbitux. Which endpoints should we use in evaluating the use of novel. Either as monotherapy or in combination with irinotecan or folfiri irinotecan, 5fluorouracil, leucovorin. In a multicenter clinical trial of patients with recurrent mcrc. Erbitux can cause serious and fatal infusion reactions. Get emergency medical help if you have signs of an allergic reaction hives, difficult breathing, swelling in your face or throat or a. Cetuximab is composed of the fv regions of a murine antiegfr antibody with human igg1 heavy and kappa light chain constant regions and has an approximate molecular. Highlights of prescribing information these highlights do not.
Guidelines for chemotherapy dosage adjustment hematology. Closely monitor serum electrolytes, including serum magnesium, potassium, and calcium, during and after erbitux administration. Cetuximab at either 500 or 750 mgm2 every other week for. Impact of cetuximab conventional dosing on cetuximabinduced. Cetuximab injection is used together with radiation treatment for advanced squamous cell carcinoma of the head and neck scchn, or with a platinumbased cancer medicine with fluorouracil to treat.
Cetuximab is the generic name for the trade name drug erbitux. Save whether you have prescription drug coverage or not. Cetuximab pharmacokinetics in endstage kidney disease under hemodialysis. The renal drug handbook the st georges hospital, adult critical. Of course im hoping i dont have to do this, but what from he tells me about erbitux its only a 2 hour infusion. Mar 17, 2012 my chemo doc is researching putting me on a maintenance chemo like erbitux. Dosing that is based on body surface area is expressed as milligrams per meter squared, or mg per m 2.
Age, sex, race, hepatic and renal function had no clinically significant effect on the pharmacokinetics of cetuximab. Get emergency medical help if you have signs of an allergic reaction hives, difficult breathing, swelling in your face or throat or a severe skin reaction fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry. Renal dysfunction in clinical studies, renal failure occurred in 1% of patients with colorectal cancer treated with cetuximab.
Heart attack or sudden death occurred in 2% of 208 patients with head and neck cancer treated with radiation therapy and erbitux in a clinical study. Taxotere docetaxel dosing, indications, interactions. Pdr drug summaries are concise pointofcare prescribing, dosing and administering information to help phsyicans more efficiently and accurately prescribe in their practice pdr s drug summaries are. Jan 24, 20 colorectal cancer crc is the third most common cancer in men and the second most common in women worldwide. Infusion reactions andcardiopulmonary arrest see full prescribing information for complete boxed warning. Dosage adjustment for cytotoxics in renal impairment. Cetuximab is an anticancer antineoplastic targeted therapy. Pharmacokinetics and safety of cetuximab in a patient with. What is the most important information i should know about cetuximab erbitux.
It is not intended as medical advice for individual conditions or treatment. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to gain access to this resource from offcampus. Welcome to the fifth edition of the renal drug handbook. Ipilimumab is a novel immunotherapy agent that has shown significant promise in the. Of the novel targeted agents, ipilumumab and cetuximab have the most. Cetuximab is an epidermal growth factor receptor egfr inhibitor used for the treatment of metastatic colorectal cancer, metastatic nonsmall cell lung cancer and head and neck cancer. This is the first reported case of the use of cetuximab in a patient. While the advice and information in this book are believed to be true and accurate at the date of publication, neither. In combination with radiation therapy or platinumbased therapy and fluorouracil. The biweekly dosing may facilitate the administration of this drug, by making this therapy more convenient for patients tabernero et al, 2008. Cetuximab erbitux is a chimeric mousehuman antibody against epidermal growth factor that is used in the treatment postoperative radiation therapy in the management of head and neck cancer view in chinese. Cetuximab side effects, dosage, interactions drugs. You can change which cookies are set at any time and find out more about them. Its a lighter chemo in that you dont lose any hair already lost mine any way, and about the worst side effect is facial and chest acne.
Erbitux approval expanded to include head and neck cancer. Of course im hoping i dont have to do this, but what from he tells me about erbitux its only a 2 hour infusion every 2 weeks. Cetuximab dosing for head and neck cancer the standard dosage of cetuximab for the treatment of squamous cell cancer of the head and neck is based on body surface area, which is normally calculated using height and weight. The information contained in the truven health micromedex products as delivered by goodrx is intended as an educational aid only. Erbitux dosing for colorectal cancer the standard dosage of erbitux for the treatment of colorectal cancer cancer of the colon and rectum is based on body surface area, which is normally calculated using height and weight. A phase ii randomized study of cetuximab at either 500 or 750. Nov 09, 2018 cetuximab is a cancer medicine that interferes with the growth and spread of cancer cells in the body. Prevention of acneiform rash caused by egfr inhibitors includes topical corticosteroids hydrocortisone 2. Cardiac arrest, respiratory arrest, andor sudden death have occurred in patients receiving cetuximab. Serious infusion reactions and cardiopulmonary arrest infusion reactions. Here, we report a 68yearold metastatic osteosarcoma patient with. Cetuximab, a recombinant chimeric monoclonal antibody, has been successfully used in the treatment of the head and neck and colorectal cancers. In combination with radiation therapy for the initial treatment of a certain type of locally or regionally advanced head and neck cancer.
For information about the 4th angel mentoring program visit. Cetuximab is given by a doctor or nurse in a medical office or infusion center. Patients who got erbitux were 10% more likely to be alive and free of cancer at three years compared with those who got chemotherapy alone. In some cases, health care professionals may use the trade name erbitux or other name c225 when referring to the generic drug name cetuximab.
Erbitux cetuximab dose, indications, adverse effects. Page 1 of 18 erbituxtm rx only 1 2 cetuximab 3 for intravenous use only. Cetuximab is approved to be used alone or with other drugs to treat. These agents should be administered with caution in patients with congenital long qtc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the qtc interval. Food and drug administration approval of erbitux cetuximab has been expanded to include latestage metastatic head and neck cancer, the agency announced. Highlights of prescribing information platinumresistant. Dosage is for either monotherapy or in combination. Erbitux cetuximab dosing, indications, interactions. In summary, electrolyte disorders, renal impairment and hypertension are the most. Cautious use of cetuximab in combination with either radiation therapy or platinumbased therapy with 5fu is warranted for head and neck cancer patients with a history of cardiac disease, specifically coronary artery disease, congestive heart failure, or cardiac arrhythmias.
Availability of mesna in the urinary tract depends on renal function. Cetuximab injection is used together with radiation treatment for advanced squamous cell carcinoma of the head and neck scchn, or with a platinumbased cancer medicine with fluorouracil to treat scchn that has come back recurrent or has spread to other parts of the body metastatic. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to gain access to this resource. Prevention and treatment of acneiform rash caused by egfr. Dec 11, 2019 in combination with radiation therapy or platinumbased therapy and fluorouracil. For the rest of the chemodrugs you can do you own homework. Erbitux cetuximab metastatic colorectal cancer and head. Erbitux, as a single agent, is indicated for the treatment of epidermal growth factor receptor egfrexpressing metastatic colorectal cancer after failure of both irinotecan and oxaliplatinbased regimens. Cetuximab is a cancer medicine that interferes with the growth and spread of cancer cells in the body cetuximab is used to treat cancers of the colon and rectum. Cetuximab is a chimeric mousehuman monoclonal antibody given by intravenous infusion that is distributed under the trade name erbitux in the u.
The renal drug handbook has developed into an essential resource for nephrologists, specialist nurses and pharmacists engaged in the care of these patients. Renal cancer achn cell subcutaneous xenografts did not grow after initiation of. Abacavir abacavir lamivudine abacavir lamivudine zidovudine acarbose acebutolol acetaminophen acetazolamide acetohexamide acetohydroxamic acid acetylsalicylic acid aspirin acrivastine acyclovir adefovir adenosine albuterol inhaled albuterol oral alfentanil alfentanil allopurinol alprazolam alteplase tissuetype plasminogen activator. Pharmacokinetics and safety of cetuximab in a patient with renal. After my surgery of left side colon had 11 doses of folfoxiri and was told that ned status,that time my cancer stage was 2. Colorectal cancer that has metastasized spread to other parts of the body. This study suggests that cetuximab can be safely used in cancer patients with renal impairment without dose adjustment. Cetuximab pharmacokinetics in endstage kidney disease under. Costs from red book 2008 drug topics red book by harold cohen 17.
Apr 18, 2008 cetuximab at either 500 or 750 mgm2 every other week for recurrent or metastatic head and neck squamous cell cancer the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Adverse renal effects of novel molecular oncologic targeted. Cetuximab at either 500 or 750 mgm2 every other week for recurrent or metastatic head and neck squamous cell cancer. Bmy today announced that the companies have agreed to. The recommended initial dose is 400 mgm 2 administered one week prior to initiating a course of. Renal drug handbook gfr 2050mlsmin dose as in normal renal function. Erbitux, as so indicated for the a single agent, is al treatment of egfrexpressing metastatic colorectal cancer in patients who are. In the literature, data on the effect of renal impairment on the pharmacokinetics of anticancer drugs are scarce. Iv infuse over 60 min qweek not to exceed an infusion rate of 10 mgmin until disease progression or unacceptable toxicity. Erbitux cetuximab metastatic colorectal cancer and. This medication is classified as a monoclonal antibody and. Cyclophosphamide and its metabolites can be eliminated by haemodialysis.
Erbituxcetuximabinjection,for intravenous use initial u. Alternate dosing of cetuximab for patients with metastatic. It is used in patients whose disease has the egfr protein and the wildtype kras gene. Furthermore, in renal cell carcinoma, an os advantage for sorafenib.