panitumumab (Vectibix)
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Indications
- EGFR-expressing metastatic colorectal carcinoma with disease progression on or following chemotherapy with fluorouracil, oxaliplatin, irinotecan
- head & neck cancer
- lung cancer[3]
Contraindications
Dosage
Single use vials: 5, 10, 20 mL, constitute to 20 mg/mL
Monitor
- serum Ca+2, serum Mg+2
- avoid sunlight
Adverse effects
- skin rash, paronychia, photosensitivity
- hypomagnesemia, hypocalcemia
- nausea, diarrhea abdominal pain, constipation
- fatigue
- severe dermatologic toxicities with possible infection
- infusion reactions
- pulmonary fibrosis
- hypersensitivity
- drug adverse effects of tyrosine kinase inhibitor(s)
- drug adverse effects of EGF receptor inhibitors
- drug adverse effects of pharmaceutical monoclonal antibodies
Drug interactions
- convurrent irinotecan, bolus 5-fluorouracil, leucovorin not recommended
Laboratory
- test for EGFR expression
- test for KRAS mutations[4]
Mechanism of action
- human IgG2 kappa monoclonal antibody against EGFR
- competitive inhibition of EGFR
- prevents autophosphorylation, activation & internalization of EGFR
- inhibits cell growth
- induces apoptosis
- decreases pro-inflammatory cytokines
- decreases vascular growth factors
- inactive in colorectal cancer patients with KRAS mutations[4]
Notes
Amgen
More general terms
References
- ↑ Monthly Prescribing Reference, Nov 2006
- ↑ Patil DT, Fraser CR, Plesec TP. KRAS testing and its importance in colorectal cancer. Curr Oncol Rep. 2010 May;12(3):160-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20425075
Tol J, Punt CJ. Monoclonal antibodies in the treatment of metastatic colorectal cancer: a review. Clin Ther. 2010 Mar;32(3):437-53. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20399983 - ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 16, 17 American College of Physicians, Philadelphia 2012, 2015
- ↑ 4.0 4.1 4.2 4.3 Peeters M, Douillard JY, Van Cutsem E et al Mutant KRAS codon 12 and 13 alleles in patients with metastatic colorectal cancer: assessment as prognostic and predictive biomarkers of response to panitumumab. J Clin Oncol. 2013 Feb 20;31(6):759-65 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23182985