Erbitux/Vectibix: Side effects
Cetuximab (Erbitux) and panitumumab (Vectibix) are not chemotherapy drugs. They are a type of targeted therapy called a monoclonal antibody, which may be given to stage IV patients alongside chemo. However, Erbitux and Vectibix are not effective in patients with RAS mutations. They also are not effective in patients with BRAF mutations, unless given with the BRAF inhibitor envorfenib (Braftovi).
Here are some side effects you might experience:
Whew, sounds like a lot, right? Remember that you likely won’t experience all of these side effects — because everyone’s bodies are different.
If you ever feel like you can’t manage your side effects and symptoms, don’t be afraid to speak with your doctor about pre-meds or complimentary meds to manage them. You can also ask for a referral to the palliative care specialist or team at your cancer center. It’s important to note that palliative care is not the same as hospice care. Palliative care helps patients manage symptoms, and it can be extremely helpful for many people.
Remember that it’s important to check in with your healthcare team before starting any supplements, complementary therapies or fasting regimens. These treatments might not be appropriate for everyone — and some may even interfere with chemotherapy.
Skin rashes
The most common Erbitux/Vectibix side effect is an acne-like skin rash. Your oncologist may prescribe an antibiotic, such as doxycycline, to help alleviate the rash. A good moisturizing cream, such as Aquaphor, can help.
Nail changes
You might have some sensitivity and inflammation around your nail beds. Left untreated, this can cause painful ingrown nails. Wearing open-toed shoes whenever possible can help. Speak to your oncologist so they can recommend treatment specific to you.
Dry and cracked skin
You might experience extremely dry skin, resulting in painful cuts on the hands and feet. Apply a good moisturizer throughout the day, particularly after washing your hands or washing dishes.
Facial hair growth
A common side effect is facial hair growth, especially on the upper lip, chin, eyelashes, and eyebrows. If this hair is unwanted, you can shave, pluck, or wax.
Sun sensitivity
When on chemotherapy and other targeted therapies, try to stay out of the sun for extended periods of time. Wear hats and protective clothing, and purchase a good sunscreen. Wear it every day — whether or not you’re planning on leaving the house!
Magnesium depletion
You might experience weak, restless legs or cramping. This can be caused by low magnesium. Your healthcare team will monitor your magnesium levels and recommend supplements if needed.
Here are some tips:
- Try epsom salt baths
- Eat foods rich in magnesium such as dark chocolate, avocados, nuts, seeds, legumes, whole grains, tofu, salmon, bananas and leafy greens
Patient perspective by Margee
Diagnosed: April 2021
Stage: IV
Type: Rectal cancer, liver metastases
I was diagnosed stage IV with mets to my liver in April 2021. After a liver biopsy, it was determined that my CRC was KRAS wild-type. This enabled me to start Vectibix in June 2021, when my chemo began (FOLFOX).
The Vectibix infuses for an hour. It is known to cause a rash in a very high percentage of people, so my oncologist has me taking a precautionary antibiotic (doxycycline). Vectibix also gives you “sun sensitivity” which can make your rash even worse.
My first few rounds of Vectibix were OK, nothing too bad. However, I developed HORRIBLE canker sores, had peeling, bleeding lips, rashes on my calves and a very painful rash on my upper chest that I think was sun-related.
My oncologist was able to prescribe Valtrex for the canker sores, which cleared them up in a day. Magic mouthwash (Benadryl, lidocaine, milk of magnesia) can also help. We reduced my dose in half at about round 4, and I really have not had too many issues since then. My lips and mouth can get a little sensitive but nothing like what happened when it was full strength!
At 9 rounds, my liver tumors had reduced by 75% — a great response to FOLFOX & Vectibix. My rectal tumor was only a “scar” (I did have 5 days of short course radiation which also contributed to this result).
When should I contact my care team?
It’s a good idea to keep a journal or notes about your side effects, so you can discuss them with your oncologist at your next appointment. This can help you advocate for changes to your pre-meds and home meds as necessary. Be sure to discuss possible side effects with your oncologist, so you know what’s normal and what might be concerning. Before your first treatment, you should have been given a 24-hour phone number to call in case of severe symptoms.
Some of these symptoms include:
- Persistent high fever
- Chest pain or chest discomfort
- Unexplained bruising or bleeding that won’t stop
- Shortness of breath
- Unusual or intense pain
- Signs of an allergic reaction, such as severe itching, swollen tongue, or difficulty swallowing
- Persistent diarrhea or vomiting
Want to learn more about side effects and how to manage them?
Join one of our COLONTOWN Facebook groups:
- Corner Cupboard is a place to discuss treatment side effects and management
- If you’re suffering from late or long-lasting side effects related to treatment, check out The Late Show
- Palliative Pathways can teach you how your palliative care team can help you
- In the Healthy Gut Cafe and Fitness Center, you can learn about how diet and exercise can help improve quality of life during treatment
- Join Live Wire to learn about icing strategies and ways to cope with neuropathy
- Cognitive Way is here to help people struggling with chemo brain
Want to join? Fill out the registration form here.