Erlotinib can be used to treat people with non-small cell lung cancer and pancreatic cancer. It can also be used to treat other types of cancer as part of a research trial.
WHAT IS ERLOTINIB?
Erlotinib is a type of treatment called a tyrosine kinase inhibitor. Kinases are important proteins for the body that regulate the way cells grow and divide.
HOW DOES ERLOTINIB WORK?
Erlotinib acts by blocking signals within the cancer cells that make them grow and divide. Blocking the signals causes them to die.
Tests can be done to check the level of epidermal growth factor receptors. These will tell you if you're likely to benefit from erlotinib. These tests can be done at the same time as the diagnosis or can be performed using samples of cancer cells from previous biopsies or surgery.
WHEN IS ERLOTINIB USED?
Non-small cell lung cancer
Erlotinib is used to treat people with non-small cell lung cancer (NSCLC) that has spread to the tissue of other parts of the body (locally advanced or metastatic cancer). It can be used as:
- the first treatment in this situation (called first-line treatment)
- a maintenance treatment for people whose cancer is stable after at least four cycles of chemotherapy
- a treatment for people whose cancer has returned after the previous chemotherapy.
Erlotinib is also used with the chemotherapy drug gemcitabine, which is administered to people with pancreatic cancer that has spread beyond the pancreas (metastatic cancer).
WHAT DOES ERLOTINIB LOOK LIKE?
Erlotinib is a whitish-yellowish tablet that is coated with a film. It comes in three dose sizes: 25 mg, 100 mg, and 150 mg.
HOW IS ERLOTINIB ADMINISTERED?
Erlotinib is usually taken with a large glass of water each morning, at least one hour before a meal or two hours afterward.
POSSIBLE SIDE EFFECTS OF ERLOTINIB
Each person reacts differently to the treatment. Some people have very few side effects, while others may develop more. The side effects described here will not affect everyone who is treated with the drug.
Here we outline the most common side effects, though we have left out the rarer ones. If you notice you develop any side effects that are not listed here, talk to your doctor or specialist nurse.
The side effects of erlotinib are normally mild, and some can be relieved with drugs.
The most common side effect of erlotinib is an acne-like rash that normally appears on the head, chest, and back. This usually develops in the first 2-3 weeks of treatment and goes away once the treatment has concluded.
Your skin may become dry and sensitive. Some people find that their nails become red, painful, and break easily.
Tell your doctor if you develop any of the following side effects, as they can prescribe medication to help.
Taking the following measures may help reduce the severity of changes to the skin, although these steps can't prevent them entirely:
- When bathing and washing, use tepid water and gentle, unscented soap.
- Avoid using skin products that contain alcohol.
- Do not use anti-acne products. These can dry out your skin and make your symptoms worse.
- Sunlight can worsen skin symptoms. During the treatment with erlotinib and for several months after it, you will be more sensitive to the sun and your skin may burn more easily than usual. You can still go out in the sun, though you need to use high-SPF sunscreen and cover yourself with clothing and a hat.
- Moisturize your skin regularly and after bathing. Your doctor or nurse specialist can recommend the best skin moisturizers.
- Wear gloves when doing household chores and when gardening.
Tell your doctor as soon as possible if you experience changes to your skin or nails, as they may be able to prescribe a treatment for this.
Though common, diarrhea is normally mild and can be controlled by taking medication. Tell your doctor if your diarrhea is severe or long-lasting. It's important to drink lots of fluids if you have diarrhea. Tell your doctor if you have black, tarry-looking stool.
Tiredness is a common side effect of cancer treatment, especially toward the end and for a few weeks after the treatment has finished. It is important that you try to pace yourself and rest as much as you need to. Try to balance this with light exercise, such as taking short walks. If you feel drowsy, don't drive or operate heavy machinery.
NAUSEA AND VOMITING
Your doctor can prescribe highly effective anti-sickness (antiemetic) drugs, which can prevent or substantially reduce your nausea and vomiting.
Some antiemetic drugs can cause constipation. Tell your doctor or nurse if this is a problem.
Some people develop soreness in the eyes (conjunctivitis) or have dryness of the eyes while they are being treated with erlotinib. Your doctor can prescribe eye drops to help this. Tell your doctor if you notice any changes in your eyes.
CHANGES TO THE WAY YOUR HAIR GROWS
Your eyelashes may grow longer and become curlier than usual. Men may notice that their beard does not grow as much. You may notice that your hair is more fine, curly, or fragile. Some people experience hair thinning or hair loss. If this happens, it normally happens gradually. These changes are normally temporary and get better once the treatment is over.
SORENESS OF THE MOUTH AND MOUTH ULCERS
Your mouth may become sore or dry or you may develop small ulcers during your treatment. Some find that sucking on ice can help. Drinking lots of fluids and regularly brushing your teeth gently using a soft-bristled toothbrush can help lower the risk of this happening. Tell your doctor or nurse if you have any of these problems, as they can prescribe a mouthwash and drugs to prevent infection in the mouth.
LOSS OF APPETITE
Some people lose their appetite while taking erlotinib. A dietitian or specialist nurse can give you advice on ways to increase your appetite and maintain your weight.
This is an uncommon side effect that affects less than 1 out of every 100 people who take erlotinib. Tell your doctor immediately if you feel suddenly out of breath, if your breathing worsens, or if you have a cough or fever. This could mean you have an inflammation in the lungs called interstitial lung disease.
ADDITIONAL INFORMATION ON ERLOTINIB
Smoking can make erlotinib less effective.
Erlotinib can interact with other drugs, including some that are used to treat stomach ulcers, indigestion, and epilepsy. It can also interact with the herbal remedy St. John's Wort. Tell your doctor if you are taking any medicines, including over-the-counter drugs, complementary therapies, and herbal medicines.
This treatment may effect your ability to conceive or give birth. It is important that you talk to your doctor before beginning treatment.
Little is known about the effects of erlotinib on developing babies. Therefore, it is not recommendable to become pregnant while taking this drug.
It is unknown whether erlotinib is present in semen or vaginal fluid. In order to protect your partner, it is safest to avoid having sex or use a barrier contraceptive device for about 48 hours after the chemotherapy.
There is a potential risk that erlotinib may be present in breast milk, and therefore women are recommended not to breast feed during the treatment and for a few months afterward.
OTHER ISSUES TO KEEP IN MIND ABOUT ERLOTINIB TABLETS
It is important to take the tablets at the appropriate time, following the instructions given to you by your doctor.
If you are being treated for a non-cancerous condition, always tell your doctor you are taking erlotinib; erlotinib treatment should not be stopped or restarted without talking to your cancer specialist first.
Keep the tablets in their original packaging at room temperature. They should be stored away from heat and direct sunlight.
Keep the tablets in a safe place out of the reach of children.
If your doctor decides to halt your treatment, return the remaining tablets to the hospital. Do not flush them down the toilet or throw them away.
Tell your doctor if you vomit right after taking the pills. You may have to take another dose. Do not take any other pills before consulting with your doctor.
If you forget to take a pill, do not take a double dose. Tell your doctor and maintain your normal dose schedule.