Erbitux and skin spot

[Guest guest]

Cetuximab (Erbitux®)

Monoclonal antibodies

Monoclonal antibodies are used to try to destroy some types of cancer cells

while causing little harm to normal cells. They are designed to recognize

certain proteins (receptors) that are found on the surface of particular cancer

cells.

Such receptors are known as epidermal growth factor receptors or EGFR. When

growth factors (such as transforming growth factor alpha and epidermal growth

factor) bind to the receptor, the cancer cell is stimulated to grow, divide

and spread.

How Erbitux works

Erbitux attaches itself to the EGF receptor inside the cell and prevents the

receptor from being activated. This stops the cells from dividing. It

therefore has the potential to stop the cancer cells from growing. It works in

a

different way from both chemotherapy and hormonal therapy.

Erbitux may also make the cancer cells more sensitive to chemotherapy.

Tests may be done to find the level of EGFR in the body before Erbitux is

given. This can help the doctors to know whether you are likely to benefit from

this treatment. Testing can be done at the same time as diagnosis of the

cancer, or samples of cancer cells from previous biopsies or surgery may be

used.

What it looks like

Erbitux is a colorless liquid.

How it is given

Erbitux is given by a drip into the vein (intravenously) through a fine tube

() inserted into a vein. The first dose is given slowly, usually over two

hours. After this, doses are given weekly and this normally takes about an

hour. The first dose is usually larger than the weekly maintenance treatments.

You may be given other medicines before Erbitux to lessen the side effects

during treatment.

Possible side effects

Each person's reaction to a cancer drug is unique. Some people have very few

side effects, while others may experience more. If you do notice any effects

which you think may be due to the drug, but which are not listed here,

please discuss these with your doctor.

The side effects of Erbitux are generally mild and some of these can be

reduced with medicines. As it is a new drug it is too early to know about all

the

possible side effects. Erbitux does not increase the side effects of

irinotecan.

Skin changes Mild skin rashes are very common. They begin during the first

two weeks of treatment and usually go away completely when the treatment

stops. Some people have more severe skin changes, which can include reddening

of

the skin and red pimples and spots on the face. The skin of the face may also

become flaky and scaly. Some people have dry skin eczema on their fingertips,

elbows and extremities, which is sore and itchy. If you have any of these

skin changes let your doctor know straight away. If you have very severe skin

problems the length of time between the treatments may be extended or the dose

may be lowered.

Treatment can be prescribed by your doctor to reduce the rash. To help

reduce the reddening it is best to avoid foods that make the skin go red, such

as

chillies and alcohol.

To help reduce the dry skin eczema it is helpful to avoid things that make

your skin dry, such as too much central heating, and soap. Your doctor can

prescribe creams to moisturize your skin.

To reduce scaly or flaky skin it is helpful to moisturize the skin and also

avoid things that make you go red.

Tiredness (fatigue) and a general feeling of weakness. It is important to

allow yourself plenty of time to rest. CancerBACUP has a section on coping with

fatigue.

Nausea (feeling sick) and less commonly vomiting. There are now very

effective anti-sickness drugs to prevent or greatly reduce this effect. If the

sickness is not controlled or continues tell your doctor, who can prescribe

other

anti-sickness drugs which may be more effective. CancerBACUP has information

on managing nausea and vomiting.

Diarrhea. This can usually be controlled with medicine but tell your doctor

if it is severe or continues. It is important to drink plenty of fluids if

you do have diarrhea.

Fever may occur. If your temperature goes above 38°C (100.5°F), contact your

doctor or the hospital straight away.

Less common side effects

Allergic reactions Signs of a reaction include skin rashes and itching; a

feeling of swelling in the tongue or throat; irritation of the nasal passages;

wheezing; a cough; and breathlessness. You will be monitored closely during

your treatment, but tell your nurse or doctor if you have any of these

symptoms. To reduce the chance of developing an allergic reaction, certain

drugs

(antihistamines) can be given before the infusion. The drip can also be slowed

down or stopped until the reaction is over.

Headaches If you have headaches, let your doctor know.

Sore mouth Your mouth may become sore, or you may notice small ulcers during

this treatment. Drinking plenty of fluids and cleaning your teeth regularly

and gently with a soft toothbrush can help to reduce the risk of this

happening. Tell your doctor if you have any of these problems. Special

mouthwashes

and medicines can be prescribed to prevent or clear any mouth infection.

Constipation Your doctor can prescribe laxatives if constipation occurs.

Lowered resistance to infection Erbitux can reduce the production of white

blood cells – making you more prone to infection. This is rare if Erbitux is

given on its own.

Contact your doctor or the hospital right away if:

your temperature goes above 38°C (100.5°F)

you suddenly feel unwell (even with a normal temperature)

Anemia (low number of red blood cells) While having treatment with Erbitux

you may become anemic. This may make you feel tired and breathless. Let your

doctor know if you feel tired or breathless or are very pale.

Tiredness and weakness While having treatment with Erbitux, some people feel

weak and tired, and as though they have no strength. This gradually

disappears once the treatment is finished.

Aching or pain in the muscles or bones This can usually be controlled with

mild painkillers, which your doctor can prescribe.

Your liver may be temporarily affected Erbitux may cause changes in the way

that your liver works, though your liver will returns to normal when the

treatment is finished. This temporary change is very unlikely to cause you any

harm, but your doctor will monitor this carefully. Samples of your blood will

be taken from time to time to check your liver function.

[Guest guest]

Hi

Does anyone know what causes these spots and why.

Also is there any treatment creams etc to use to keep them under control are

they itchy or

uncomfortable.

thanks

in Spain

[Guest guest]

There are prescription drugs for the rash. My dr. prescribed

minocycline at first but I was allergic to the cream. Then she

prescribed flutacasone propitionate(?). That worked ok. The research

nurse told me people were using head and shoulders shampoo on the

spots. I did not try that one though. I also used caladryl lotion.

Mine frequently got infected so I had to take antibiotics several

times. Be happy though because if you have a good rash it is supposed

to mean the drug is working. Aren't those spots fun!!

Jane

>

> Hi

>

> Does anyone know what causes these spots and why.

>

> Also is there any treatment creams etc to use to keep them under

control are they itchy or

> uncomfortable.

>

> thanks

>

> in Spain