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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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This information is about erlotinib, which is also known as Tarceva®. It can be used to treat people with advanced non-small cell lung cancer (NSCLC)|. Erlotinib may also be used to treat other types of cancer as part of a research trial.
Trials are in progress to find out if erlotinib is best given alone or in combination with chemotherapy or radiotherapy.
Erlotinib belongs to a group of cancer drugs known as epidermal growth factor receptor (EGFR) inhibitors. It is a type of drug called a tyrosine kinase inhibitor. It can be used to treat some people with non-small cell lung cancer (NSCLC)|. Erlotinib may also be used, in combination with the chemotherapy| drug gemcitabine|, to treat people with pancreatic cancer| that has spread beyond the pancreas (metastatic cancer).
Erlotinib is also being studied as a possible treatment for many other cancers, including ovarian cancer| and cancer of the head and neck|. These studies are being carried out on cancers that have come back after initial treatment (recurrent cancers), or have spread to other parts of the body (advanced or metastatic cancers).
The National Institute for Health and Clinical Excellence (NICE) gives advice on which new drugs and treatments should be available on the NHS in England and Wales. The Scottish Medicines Consortium (SMC), are an organisation similar to NICE for the NHS in Scotland.
NICE and the SMC have approved erlotinib as an alternative treatment to the chemotherapy drug docetaxel| for people with non-small cell lung cancer whose cancer has come back after, or not responded to at least one course of chemotherapy.
NICE hasn't issued guidance on the use of erlotinib as a treatment for pancreatic cancer in the NHS in England and Wales.The SMC has advised that erlotinib, in combination with gemcitabine, is not recommended for the treatment of patients with metastatic pancreatic cancer within NHS Scotland.
We can give you more information| on what to do if a treatment isn't available.
Epidermal growth factor receptor inhibitors are used to try to destroy some types of cancer cells while causing little harm to normal cells.
Structures called epidermal growth factor receptors (EGFRs) sit on the surface of many types of cancer cells. Epidermal growth factor is a protein present in the body. The receptors allow epidermal growth factor to attach to them. When these growth factors bind to the receptors, a protein called tyrosine kinase (TK) triggers chemical signals to make the cell grow and divide.
Erlotinib attaches itself to the tyrosine kinase protein and prevents the chemical signals from being produced. This may stop the cell dividing. Erlotinib therefore may be able to stop the cancer cells from growing. It works in a different way from both chemotherapy| and hormonal therapy| .
Tests may be done to check the level of EGFR. These will tell if you are likely to benefit from Tarceva®. Testing can be done at the same time as diagnosis, or samples of cancer cells from previous biopsies or surgery may be used.
Erlotinib is a tablet.
It is taken as a single dose each morning with a large glass of water, at least one hour before a meal, or two hours afterwards.
Each person’s reaction to an anti-cancer drug is different. Some people have very few side effects, while others may experience more. If you notice any effects which you think may be due to the drug, but are not listed here, please discuss them with your doctor.
The side effects of erlotinib are generally mild and some of them can be reduced with medicines. As it is still a new drug, it is too early to know everything about the possible side effects.
Skin changes Many people develop a rash, particularly on their face, neck, chest, back and arms. This generally starts about 8–10 days after starting treatment and improves after a few weeks. Sunlight may make the rash worse, so if you are out in the sun wear a hat and sun protection cream of SPF15 or higher. Let your doctor know if you develop a rash or notice any other skin changes.
Diarrhoea This is common but usually mild, and can generally be controlled with medicine. Tell your doctor if it is severe or continues. It is important to drink plenty of fluids if you have diarrhoea| . Let your doctor know if you develop any black, 'tarry-looking' stools.
Tiredness (fatigue) and a general feeling of weakness Balancing periods of rest with gentle exercise, such as short walks, may help fatigue| .
Feeling sick and being sick It is quite common to feel sick| but this can usually be controlled. Some people will actually be sick. Your doctor can prescribe anti-sickness (anti-emetic) drugs to prevent or greatly reduce this. If the sickness is not controlled, or if it continues, tell your doctor. They can prescribe other anti-sickness drugs which may be more effective.
Eye problems Some people develop sore, red eyes (conjunctivitis) or dry eyes while they are being treated with erlotinib. Your doctor can prescribe eye drops to help with this. Let your doctor know if you notice any changes to your eyes.
Hair loss Your hair may become thinner but it's very unlikely you will lose all of it. Any hair loss| is temporary and your hair will grow back once treatment is over.
Sore mouth Erlotinib can cause a sore mouth| or mouth ulcers. Drinking plenty of fluids and cleaning your teeth regularly can help. Tell your nurse or doctor if you have any problems. They can prescribe special mouthwashes and medicines to prevent or clear any mouth infection.
Loss of appetite If you don't feel like eating it may be helpful to speak to a dietitian at the hospital.
Breathing problems This is an uncommon side effect that affects fewer than 1 in 100 people taking erlotinib. If you suddenly become breathless| or your breathing worsens, possibly with a cough or high temperature, tell your doctor immediately. It may mean you have an inflammation of the lungs called interstitial lung disease.
Some other medicines can be harmful to take when you are having erlotinib. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies| and herbal drugs or vitamins.
Contraception It is not advisable to become pregnant or father a child while taking erlotinib, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. It is important to discuss this with your doctor.
Smoking This may make erlotinib work less effectively.
This section has been compiled using information from a number of reliable sources, including:
For further references, please see the general bibliography| .
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