Classification: Monoclonal Antibody
Panitumumab is a type of medication called a monoclonal antibody that binds specifically to the epidermal growth factor receptor (EGFR). EGFR is abnormally over-expressed in many cancers (including those of the colon and rectum), so inhibition of EGFR can result in a decrease in tumor cell growth and decreased production of other factors responsible for metastasis (tumor spread). Panitumumab exerts its cancer fighting properties by competitively inhibiting the binding of epidermal growth factor to EGFR, which prevents epidermal growth factor from working and hence not allowing cancer growth to occur.
Panitumumab is given as an intravenous (into a vein) infusion, over 60 minutes, once every 14 days. The actual dose is based on your body size and will be determined by your healthcare provider.
There are a number of things you can do to manage the side effects of Panitumumab. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
Panitumumab has some unique nail and skin side effects that you may develop. Patients may develop a rash. While this rash may look like acne, it is not, and should not be treated with acne medications. The rash may appear red, swollen, crusty and dry and feel sore. You may also develop very dry skin, which may crack, be itchy or become flaky or scaly. The rash typically starts in the first week of treatment, but can occur at any time during treatment. Tips for managing your skin include:
While receiving panitumumab, you may develop an inflammation of the skin around the nail bed/cuticle areas of toes or fingers, which is called paronychia. It can appear red, swollen or pus filled. Nails may develop "ridges" in them or fall off. You may also develop cuts or cracks that look like small paper cuts in the skin on your toes, fingers or knuckles. These side effects may appear several months after starting treatment, but can last for many months after treatment stops.
Take anti-nausea medications as prescribed. If you continue to have nausea or vomiting, notify your doctor or nurse so they can help you manage this side effect. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms. Read the Nausea & Vomiting Tip Sheet for more suggestions.
Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.
While on cancer treatment you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team and see OncoLink’s section on fatigue for helpful tips on dealing with this side effect.
Your oncology team can recommend medications to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and seeds. Soluble fiber is found in some foods that absorbs fluid and can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange and grapefruit sections, boiled potatoes, white rice and products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Drink 8-10 glasses on non-alcoholic, un-caffeinated fluid a day to prevent dehydration. Read Low Fiber Diet for Diarrhea for more tips.
The infusion can cause a reaction that may lead to chills, fever, low blood pressure, and difficulty breathing. Let your nurse know right away if you experience any problems during the infusion.
While receiving panitumumab, your eyelashes may grow very fast, become very long and bother your eyes. To avoid irritation, keep them trimmed and do not bleach or pluck them. Some patients may develop irritation or damage to the cornea (clear part covers the eyeball) or changes in your eyesight. Notify your healthcare team if you develop any eye pain or vision changes.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication, or for 6 months after treatment is stopped. Effective birth control is necessary during treatment, even if your menstrual cycle stops or you believe your sperm is affected.
Panitumumab can cause a decrease in the amount of magnesium in your blood. Your healthcare team will monitor for this and you may need to take magnesium supplements. In studies, some patients experienced serious lung problems. If you develop any difficulty breathing, cough or wheezing, notify your healthcare team right away.