Cetuximab (Erbitux)

Find out what cetuximab (Erbitux) is, how you have it and other important information about taking cetuximab (Erbitux).

Cetuximab is a cancer treatment drug and is also known by its brand name Erbitux.

It is a treatment for:

  • advanced bowel cancer 
  • head and neck cancer 

How it works

Some cancer cells have receptors called epidermal growth factor receptors (EGFR) on their surface. A protein produced naturally in the body called epidermal growth factor (EGF) attaches to the receptors. This triggers the cell to grow and divide into more cells. Cetuximab works by attaching itself to the EGF receptors. This blocks the EGF protein from reaching the cancer cells and stops them from growing.

Studies have shown that cetuximab doesn't work in people whose bowel cancer cells have a genetic change called a k-ras mutation. Around 4 out of 10 people (40%) with bowel cancer have a k-ras mutation. So doctors will test your tumour sample to see if you have a normal k-ras gene before starting treatment.

How do you have cetuximab?

You have cetuximab as a drip into your bloodstream. 

Into your bloodstream

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have cetuximab

You usually have cetuximab once a week. It takes about 2 hours the first time you have it. If you don’t have any problems, the following treatments take an hour.

How long you have cetuximab depends on your cancer type.

For advanced bowel cancer

You have cetuximab on its own or with other chemotherapy drugs. This usually continues for as long as it is helping you and the side effects aren’t too bad.

For head and neck cancer

You may have cetuximab every week, during your radiotherapy treatment. Or you may have it with chemotherapy, for as long as the treatment is helping you and the side effects aren’t too bad. 

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Blood clots

You are more at risk of developing a blood clot during treatment. Drink plenty of fluids and keep moving to help prevent clots.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

  • other vaccines, but they might not give you as much protection as usual
  • the flu vaccine (as an injection)
  • the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system Open a glossary item recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you're having treatment and for a few months afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.

Other medicines

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

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