Class: Targeted Therapy
Generic Name: Panitumumab
Trade Name: Vectibix®
For which conditions is Vectibix approved for? Vectibix is indicated for the treatment of patients with wild-type KRAS (exon 2 in codons 12 or 13) metastatic colorectal cancer as determined by an FDA-approved test. Vectibix is used for the treatment of metastatic colorectal cancer that expresses the epidermal growth factor receptor (EGFR) and that has worsened during or after fluoropyrimidine, oxaliplatin, and irinotecan chemotherapy regimens; it is also used as first-line therapy in combination with FOLFOX.
Vectibix is not indicated for the treatment of patients with RAS-mutant metastatic colorectal cancer or for whom RAS mutation status is unknown.
It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than for which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Vectibix belongs to a class of drugs called monoclonal antibodies. Vectibix produces its anticancer effects by targeting the epidermal growth factor receptor (EGFR). EGFR is a protein found on the surface of some cells; it is important for cellular growth, replication, and spread.
How is Vectibix typically given (administered)? Vectibix is administered intravenously (into a vein). The dose depends on several factors, including the patient’s weight and ability to tolerate Vectibix. Severe infusion reactions may occur during the administration of Vectibix. Patients will be closely monitored during and after infusions.
How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with Vectibix. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver, and electrolyte levels will be monitored. Patients may also undergo physical examinations, scans, or other measures to assess side effects and response to therapy. In addition, patients will be monitored for the development of severe rash and allergic or severe infusion reactions (may include airway obstruction, fever, chills, or low blood pressure), eye complications, and lung complications. Vectibix should be stopped for dermatologic or soft tissue toxicity associated with severe or life-threatening inflammatory or infectious complications as well as for pulmonary fibrosis and severe lung disease.
What are the most common side effects of treatment with Vectibix?
- Skin abnormalities (rash, hives, dry skin, acne-like or pus-filled sites, cracks in skin, flaky or peeling skin)
- Nail abnormalities
- Low levels of magnesium
- Abdominal pain
Vectibix may also cause eye or lung problems in some patients, as well as death of skin tissue (skin necrosis), angioedema, and life-threatening blisters on the skin or mucous membranes (fatal bullous mucocutaneous disease).
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
- Pay careful attention to the physician’s instructions and inform the physician of any side effects.
- Maintain adequate rest and nutrition.
- Wear sunscreen and protective clothing and try to minimize sun exposure.
- Eat small meals frequently to help alleviate nausea.
Are there any special precautions patients should be aware of before starting treatment?
- Vectibix should not be used in patients with mutant RAS (exons 2, 3, 4 of KRAS and NRAS) metastatic colorectal cancer or for whom RAS mutation status is unknown.
- RAS mutational status should be determined before beginning treatment with Vectibix. Based on clinical trial findings regarding survival, Vectibix should not be used in patients with RAS-mutant (exons 2, 3, 4 of KRAS and NRAS) metastatic colorectal cancer or for whom RAS mutation status is unknown.
- Patients should inform their physician if they are pregnant, breastfeeding, or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment.
- It is important that patients inform their physician about all other medical conditions.
- Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
- Patients should check with their physician before starting any new drug or nutritional supplement.
- Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
When should patients notify their physician?
Patients should inform their physician if they experience side effects that bother them or don’t go away, or if they experience:
- Rash or other skin or nail abnormality,
- Difficulty breathing or shortness of breath,
- Persistent or severe fatigue,
- Abnormalities involving the eyes,
- Extreme or persistent nausea and vomiting,
- Persistent diarrhea, or
- Persistent or recurrent coughing, wheezing, or facial swelling
What is a package insert? A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some of clinical trials, chemical structure, pharmacokinetics, and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
Important Limitations of Use
The information provided above on the drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice. Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.
As with any printed reference, the use of particular drugs, regimens and drug dosages may become out-of-date over time, since new information may have been published and become generally accepted after the latest update to this printed information. Please keep in mind that health care professionals are fully responsible for practicing within current standards, avoiding use of outdated regimens, employing good clinical judgment in selecting drugs and/or regimens, in calculating doses for individual patients, and verifying all dosage calculations.
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