Drug Action
Panitumumab is a monoclonal antibody that binds to the epidermal growth factor receptor (EGFR).
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Drug reference
Panitumumab is a monoclonal antibody that binds to the epidermal growth factor receptor (EGFR).
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Treatment of non-mutated RAS metastatic colorectal cancer (combination therapy) | Treatment of non- mutated RAS metastatic colorectal cancer (monotherapy after failure of fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy regimens) ▶BY INTRAVENOUS INFUSION ▶Adult: (consult product literature)
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Interstitial pulmonary disease. the combination of panitumumab with oxaliplatin-containing chemotherapy is contra-indicated in patients with mutant RAS metastatic colorectal cancer or for whom RAS status is unknown
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History of keratitis. history of severe dry eye. history of ulcerative keratitis. pulmonary disease— discontinue if interstitial lung disease develops. risk factors for keratitis. risk factors for severe dry eye. risk factors for ulcerative keratitis (including contact lens use)
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Evidence of non-mutated RAS status (at exons 2, 3 and 4 of KRAS and NRAS) is required before panitumumab treatment is initiated, and should be determined by an experienced laboratory using a validated test method.
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NICE decisions ▶Cetuximab, bevacizumab and panitumumab for the treatment of metastatic colorectal cancer after first-line chemotherapy (January 2012) NICE TA242 Panitinumab (Vectibix ®) monotherapy is not recommended for the treatment of patients with metastatic colorectal cancer that has progressed after first- line chemotherapy. www.nice.org.uk/guidance/ta242 ▶Cetuximab and panitumumab for previously untreated metastatic colorectal cancer (updated September 2017) NICE TA439 Panitumumab (Vectibix ®) is recommended, within its marketing authorisation, as an option for previously untreated RAS wild-type metastatic colorectal cancer in adults in combination with: . 5-fluorouracil, folinic acid and oxaliplatin (FOLFOX), or . 5-fluorouracil, folinic acid and irinotecan (FOLFIRI). This advice is contingent upon the manufacturer providing panitumumab with the discount agreed in the patient access scheme. www.nice.org.uk/guidance/ta439
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MHRA/CHM ADVICE: SEVERE SKIN REACTIONS Severe skin reactions have been reported very commonly in patients treated with panitumumab. Patients receiving panitumumab who have severe skin reactions or develop worsening skin reactions should be monitored for the development of inflammatory or infectious sequelae (including cellulitis, sepsis, and necrotising fasciitis). Appropriate treatment should be promptly initiated and panitumumab withheld or discontinued. MHRA/CHM ADVICE: EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) INHIBITORS: SERIOUS CASES OF KERATITIS AND ULCERATIVE KERATITIS (MAY 2012) Keratitis and ulcerative keratitis have been reported following treatment with epidermal growth factor receptor (EGFR) inhibitors for cancer (cetuximab, erlotinib, gefitinib and panitumumab). In rare cases, this has resulted in corneal perforation and blindness. Patients undergoing treatment with EGFR inhibitors who present with acute or worsening signs and symptoms suggestive of keratitis should be referred promptly to an ophthalmology specialist. Treatment should be interrupted or discontinued if ulcerative keratitis is diagnosed.
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→Appendix 1: monoclonal antibodies
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▶Common or very common Alopecia. anaemia. anxiety. appetite decreased. asthenia. chest pain. chills. constipation. cough. dehydration. diarrhoea. dizziness. dry eye. dry mouth. dyspnoea. electrolyte imbalance. embolism and thrombosis. eye discomfort. eye disorders. eye inflammation. fever. flushing. gastrointestinal discomfort. gastrooesophageal reflux disease. haemorrhage. hair changes. headache. hyperglycaemia. hyperhidrosis. hypersensitivity (may be delayed). hypertension. hypotension. increased risk of infection. insomnia. leucopenia. mucositis. nail disorders. nausea. oral disorders. pain. peripheral oedema. skin reactions. skin ulcer. tachycardia. vomiting. weight decreased ▶Uncommon Angioedema. cyanosis. infusion related reaction. nasal dryness. onycholysis. respiratory disorders . severe cutaneous adverse reactions (SCARs) ▶Rare or very rare Anaphylactic reaction
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Manufacturer advises effective contraception during and for 6 months after treatment.
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Avoid (toxicity in animal studies). See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Manufacturer advises avoid breastfeeding during and for 2 months after treatment.
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▶Monitor for hypomagnesaemia. ▶Monitor for hypocalcaemia. ▶Monitor for dermatological reactions including Stevens- Johnson syndrome and toxic epidermal necrolysis (consult product literature).
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There can be variation in the licensing of different medicines containing the same drug. Solution for infusion ELECTROLYTES: May contain Sodium ▶Vectibix (Amgen Ltd) Panitumumab 20 mg per 1 ml Vectibix 400mg/20ml concentrate for solution for infusion vials | 1 vial P £1,517.16 (Hospital only) Vectibix 100mg/5ml concentrate for solution for infusion vials | 1 vial P £379.29 (Hospital only) Immune system and malignant disease
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(consult product literature)
First-line fragment. Read the complete Indications and Dose section above.
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