Gefitinib is a drug that can be used to treat non-small cell lung cancer or other types of cancer as part of a research trial.
WHAT IS GEFITINIB?
Gefitinib 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 GEFITINIB WORK?
Gefitinib acts by blocking signals within cancer cells. Blocking the signals causes them to die.
WHEN IS GEFITINIB USED?
Gefitinib is used to treat some people who have non-small cell lung cancer (NSCLC).
The drug only works for cases of NSCLC that have changes called EGFR mutations on the surface of their cells. EGFR mutations are most likely to occur in NSCLC in:
- people who have never smoked
- people with adenocarcinoma (a specific type of NSCLC)
- people of Asian ancestry
There are tests to check the level of EGFR. These tests will help you and your doctors decide whether you are likely to benefit from treatment with gefitinib. These tests can be done at the same time as diagnosis or can be performed using samples of cancer cells from previous biopsies or surgery.
WHAT DOES GEFITINIB LOOK LIKE?
Gefitinib is a round, brown tablet that is coated with a film.
HOW IS GEFITINIB ADMINISTERED?
Gefitinib is taken once a day in tablet form. You should take your tablet at about the same time each day. The tablets should be taken with a glass of water, on an empty or a full stomach. If you have difficulty swallowing the pills, gefitinib can be dissolved in a glass of water; after about 20 minutes in the glass, the drug dissolves completely and is ready to be drunk immediately. After drinking the dissolved pill, fill the glass with water again and drink it.
POSSIBLE SIDE EFFECTS OF GEFITINIB
Each person reacts differently to cancer 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.
We outline the most commonly 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 most common side effect of gefitinib 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 also turn dry and become more sensitive. Some people find that their nails hurt, become red, and break easily.
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, as these can dry out your skin and make your symptoms worse.
- Moisten your skin regularly and after bathing. Your doctor or nurse specialist can recommend the best skin moisturizers.
- Protect your hands and nails from detergent by wearing rubber gloves to wash dishes.
Protect your skin from the sun, as sunlight can worsen skin symptoms. During the treatment with gefitinib 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.
Tell your doctor as soon as possible if you experience changes to your skin or nails. They may prescribe a treatment to help you with this. For people who develop more severe side effects, their gefitinib treatment may be stopped for a few days to allow the skin to recover.
Gefitinib can cause diarrhea. Normally, this can be easily controlled with drugs, so tell your doctor if your diarrhea is severe or ongoing. It's important to drink lots of fluids if you have diarrhea.
LOSS OF APPETITE
Some people lose their appetite while taking gefitinib. A dietitian or specialist nurse can give you advice on ways to increase your appetite and maintain your weight.
NAUSEA AND VOMITING
Your doctor can prescribe effective antiemetic drugs, which can prevent or substantially reduce your nausea or vomiting. If your nausea remains uncontrolled or continues, tell your doctor, as they can prescribe other drugs that could work better.
Some antiemetic drugs can cause constipation. Tell your doctor or nurse if this is a problem.
Tiredness is a common side effect of cancer treatment, especially toward the end of the treatment and for a few weeks after it 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.
CHANGES IN THE LIVER
Treatment with gefitinib can cause changes in the way your liver works, although this will return to normal once your treatment is over. It is very unlikely you will notice any problems, though your doctor will take periodic blood samples to check whether your liver is working properly.
CHANGES TO YOUR HAIR
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 lose their hair. If this happens, it normally happens gradually. These changes are normally temporary and get better little by little once the treatment is over.
If you notice any changes in your vision, eye soreness, or reddening of the eyes, talk to your doctor immediately.
Tell your doctor if you get nosebleeds or notice blood in your urine while taking gefitinib.
This is an uncommon side effect that can affect 1 out of every 100 people who take gefitinib. If you become short of breath, of your breathing worsens, or if you have a cough or fever, let your doctor know immediately. This could mean you have an inflammation in the lungs called interstitial lung disease. This is a potentially severe condition. If you are concerned about this possible side effect, talk to your doctor or nurse.
It is important to tell your doctor immediately if you feel unwell or have severe side effects, even if these are not among those mentioned above.
Some drugs, including those bought over the counter in a store or pharmacy, may be harmful to you while you are taking gefitinib. Tell your doctor if you are taking any medicines, including over-the-counter medications, complementary therapies, and herbal medicines.
This treatment may affect your ability to conceive. It is important that you talk to your doctor before beginning treatment.
Little is known about the effects of gefitinib on developing babies. Therefore, it is not recommendable to become pregnant while taking this drug.
It is unknown whether gefitinib 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 gefitinib may be present in breast milk, and therefore women are recommended not to breast feed during the treatment and for a few months afterward.
If you are admitted to the hospital for any reason not related to cancer, it is important that you tell your doctors and nurses caring for you that you are being treated with gefitinib. Your should give them the name of your cancer specialist so that they can consult with him or her.
OTHER ISSUES TO KEEP IN MIND ABOUT GEFITINIB TABLETS
It is important to take the pills as indicated by your doctor.
If you are being treated for a non-cancerous condition, always tell your doctor you are taking gefitinib; gefitinib treatment should not be stopped or restarted without talking to your cancer specialist first.
Keep the pills in their original packaging at room temperature. They should be stored away from heat and direct sunlight.
Keep them 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.
If you vomit right after taking the tablets, let your doctor know, as you may need to take another dose. Do not take any more doses until you talk to your doctor.
If you forget to take a pill, take it as you realize you have skipped a dose. However, if there are fewer than 12 hours left before the next scheduled dose, do not take the pill you forgot to take before. You should never double your dose.