During treatment, you will see a cancer doctor or nurse. This is who we mean when we mention a doctor or nurse in this information.
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Panitumumab is a targeted therapy drug used to treat bowel cancer that has spread to other parts of the body (advanced bowel cancer). It is best to read this information with our general information about bowel cancer.
Panitumumab is usually given into a vein. You usually have it as an outpatient. Your cancer doctor or nurse will tell you how often you will have it.
Like all targeted therapy drugs, panitumumab can cause side effects. Some side effects can be serious, so it’s important to read the detailed information below. Your healthcare team can talk to you more about this and give you advice on how to manage any side effects.
Tell your doctor or nurse straight away if you:
Rarely, side effects may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
If you need to seek medical attention for any reason other than the cancer, always tell the healthcare staff that you are having this treatment.
During treatment, you will see a cancer doctor or nurse. This is who we mean when we mention a doctor or nurse in this information.
Panitumumab is a type of drug called a monoclonal antibody. These drugs are sometimes called targeted therapies. They work by ‘targeting’ specific proteins (receptors) on the surface of cells.
Certain cancers have receptors on their surface called epidermal growth factor receptors (EGFRs). A protein called epidermal growth factor activates them, causing the cancer cells to grow. Panitumumab locks on to the EGFRs and stops this happening.
When treating bowel cancer, panitumumab only works on bowel cancers that have a normal RAS gene. The RAS gene helps control cell growth. Before panitumumab is used, doctors test the bowel cancer cells for changes (mutations) in this gene.
Panitumumab can be used to treat people with bowel cancer that has spread to other areas of the body (advanced or metastatic). It can be given with chemotherapy. Or it can be given on its own after chemotherapy treatments have been tried.
Panitumumab may only be available in some situations. Your cancer doctor can tell you if it is suitable for you. Some people may be given it as part of a clinical trial. If a drug is not available on the NHS, there may be different ways you are still able to have it. Your cancer doctor can give you advice.
A nurse gives you panitumumab as a drip into a vein (intravenous infusion). You have the first infusion slowly, usually over about 60 minutes.
If you do not have any problems, you can have your next treatment over 30 to 60 minutes.
Some people are given higher doses of panitumumab. These infusions are given over about 90 minutes. You usually have panitumumab once every two weeks.
We have included the most common side effects of panitumumab here. We have not included all the less common and rarer side effects. You may get some of the side effects we mention, but you will not get them all. Always tell your doctor or nurse about any side effects you have.
If you have chemotherapy with panitumumab, some side effects may be worse. You may also have side effects not listed here. We have more information about chemotherapy.
Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist has explained. This will help the drugs work as well as possible for you.
Your nurse will give you advice about managing side effects. After your treatment is over, the side effects will start to improve.
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
About 1 in 20 people (5%) have an allergic reaction to panitumumab. It is most likely to happen when the drug is being given or for up to an hour afterwards. You may be given drugs before the infusion to reduce the chance of a reaction.
If you have a reaction, the nurses usually treat this by slowing the infusion. You will have the rest of your treatments at a slower rate. A reaction is usually mild, but rarely it can be more severe.
You will be monitored closely during treatment. But tell your nurse or doctor if you feel unwell or have any of the following symptoms:
Rarely, people may get a reaction up to 24 hours or more after treatment. If you have any of these symptoms or feel unwell after you get home, contact the hospital straight away.
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) to download a Patient Information Leaflet (PIL) for this drug. The leaflet lists all known side effects.
Most people having panitumumab will have skin changes during treatment.
The most common side effect is an acne-like rash on the face, neck and body. This usually begins during the first 2 or 3 weeks of treatment and goes away a few weeks after treatment ends.
Your skin may also become dry, itchy or scaly, and it may feel tender. The skin around your nails may become red and sore. Your nails may become brittle and break.
Very rarely, people may have a severe skin reaction. The symptoms can include large blisters, peeling skin or sores in the mouth. You may also have a fever (high temperature). Contact the hospital straight away if this happens.
Always tell your doctor or nurse about any skin changes. They can give you advice and prescribe creams or medicines to help. If you have severe skin problems, your doctor may suggest a longer time between treatments or a lower dose of panitumumab.
Panitumumab can reduce the number of white and red blood cells. This is more likely if you are having chemotherapy at the same time. You will have regular blood tests to check the number of blood cells. Sometimes your treatment may be delayed until these levels recover.
If your number of white blood cells is low, you are more likely to get an infection.
Contact the hospital straight away if:
Symptoms of an infection include:
This treatment can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this.
If you are very anaemic, you may need a drip to give you extra blood cells. This is called a blood transfusion.
Your doctor can give you anti-sickness drugs to help prevent or control sickness. If you still feel sick, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.
You may have diarrhoea or tummy pain. Some people become constipated, but this is less common. Your doctor can give you drugs to help. If you are also having chemotherapy, diarrhoea may be more severe. Follow any instructions the hospital give you. If you have diarrhoea or constipation, make sure you drink at least two litres (three and a half pints) of fluids every day.
Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.
Your mouth may become sore or dry and you may get small ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth or dentures morning and night and after meals. Use a soft-bristled or children’s toothbrush. Your nurse might advise you to use mouthwashes. It is important to follow any advice you are given and to drink plenty of fluids.
Tell your nurse or doctor if you have any problems with your mouth. They can prescribe medicines to prevent or treat mouth infections and reduce soreness.
Your eyelashes may grow longer and more curly than usual. Men may notice less beard growth. You may notice your head and body hair is finer, curlier or more brittle. Some people may lose their hair slowly over several months. These changes are usually temporary and gradually improve once treatment is over.
Your eyes may water and feel sore. They may become more sensitive to light. Your doctor can give you eye drops to help with this. If your eyes get red and inflamed (conjunctivitis), tell your doctor. You may need antibiotic eye drops. Panitumumab may also cause blurred vision or painful eyes. Always tell your doctor or nurse if your eyes are painful or if there is a change in your vision.
Some people have indigestion or acid reflux. Acid reflux is when acid comes up from the stomach into the gullet (oesophagus). Tell your doctor if this happens. They can give you treatment to help.
During treatment, you may lose your appetite. Try to eat small meals regularly. If your appetite does not improve after a few days, let your nurse or dietitian know. They can give you advice on improving your appetite and keeping to a healthy weight.
This is usually mild, but may be more severe if you have an existing lung problem. Let your doctor know if you have a cough or become more breathless.
You will have regular blood tests to check this. If the levels are too low, your doctor may prescribe supplements.
Some people have back pain while having treatment with panitumumab. If this becomes a problem, ask your doctor for advice about painkillers.
Your ankles and legs may swell because of fluid building up. Tell your doctor or nurse if this happens. The swelling gets better after your treatment ends.
Some people have problems sleeping or feel anxious during treatment. Tell your doctor or nurse if you notice these symptoms.
Having sore and red palms of hands and soles of feet is called palmar-plantar or hand-foot syndrome. It gets better when treatment ends. Your doctor or nurse can give you advice and prescribe creams to improve the symptoms. It can help to keep your hands and feet cool and to avoid tight-fitting socks, shoes and gloves.
This treatment may raise your blood sugar levels. Symptoms of raised blood sugar include:
Tell your doctor or nurse if you have these symptoms. If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this.
This treatment can increase the chances of a blood clot. A clot can cause:
Contact your doctor straight away if you have any of these symptoms. A blood clot is serious, but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Your blood pressure may become higher or lower than normal. Tell your nurse or doctor if you have headaches or feel dizzy. These can be signs of blood pressure changes.
It is important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they are not mentioned above.
It can be harmful to take some medicines when you are having panitumumab. Tell your doctor about any medicines you are taking. This includes over-the-counter drugs, complementary therapies and herbal drugs.
Doctors don’t yet know how this treatment may affect your fertility (the ability to become pregnant or father a child). If you are worried about this, talk to you doctor before treatment starts.
Your doctor will advise you not to get pregnant or father a child while having this treatment and for some time afterwards. The drugs may harm the developing baby. It is important to use effective contraception.
Women are advised not to breastfeed while having this treatment and for some time afterwards. This is because the drugs could be passed to the baby through breast milk.
If panitumumab affects your concentration or vision, do not drive while on this treatment.
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having this treatment.
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