Necitumumab (Intravenous)

Overview

Necitumumab is a type of anti-cancer medication known as a monoclonal antibody, and works by altering the immune system. It leads the immune system to attack cancer cells, and thus inhibits or even stops their growth. It is often prescribed with other drugs such as gemcitabine and cisplatin to treat squamous non-small cell lung cancer.

Patients are given the medicine intravenously by a healthcare professional. Treatment and effects should be carefully monitored by the doctor during scheduled check-ups to ensure the medicine is working as intended.

Although subject to the possible development of side effects, patients prescribed necitumumab are hoped to make a recovery from cancer, and to continue living their life in full.

Conditions Treated

  • Non-small cell lung cancer

Type Of Medicine

  • Monoclonal antibody

Side Effects

Like most medications, treatment with necitumumab may may lead to the development of side effects, although not all patients will encounter unwanted effects. It is recommended for the patient to discuss their issues and questions with the doctor, and to check if there are ways to mitigate these side effects, such as regular medical check-ins. Although there may be negative effects from using the medication, it is prescribed if the doctor feels that the benefits of treatment outweigh the risks.

During the course of treatment, patients should monitor themselves for unusual signs and symptoms. Side effects may range from mild to severe. The following lists of side effects are not exhaustive, and patients may wish to check with their doctor for a complete list of side effects. If they notice any symptom that is not listed here, they should contact their doctor for further advice.

Some side effects may occur with necitumumab that should go away with time. However, patients may want to seek medical attention if they have any doubts or questions about the effects, or if these symptoms persist or worsen with time.

  • Skin blemishes such as pimples

In addition to stomach problems, the patient may encounter severe nausea and vomiting. They may approach their doctor for a prescription of medicine to stop or alleviate the nausea and vomiting. Patients can also mediate these symptoms by limiting their physical activity, by not eating before a dose of the medicine, or by eating several smaller meals throughout the day rather than three main ones. If the nausea and vomiting get worse, patients should tell their doctor right away.

Use of necitumumab may cause skin problems. These can include irritation to the skin, rashes, or acne. Redness, pain and swelling of the skin around the fingernails may also occur, as well as loosening of the fingernails themselves. It is important for patients to notify the doctor if these skin problems happen so that they can adjust the dosage to alleviate the problems, or even to stop treatment with this medication altogether.

While rare, treatment with necitumumab may cause blood clots, and problems such as strokes, heart attacks, deep vein thrombosis (DVT) or pulmonary embolisms. This risk increases if the patient has a medical history of heart disease, strokes, blood clots or if they have been immobile (such as in cases of being bed-ridden or having recently been on a long flight). In such cases, the patient should inform their doctor of their medical history. The usage of products with estrogen in them may also contribute to the risk of blood clots. Patients should look out for the following signs:

  • Sudden changes in vision

Some other serious side effects that may occur include:

  • Muscle spams

During treatment, patients may also develop a serious reaction to the injection, and show symptoms such as:

  • Problems with breathing

Side effects may be serious, and if patients notice that they have developed side effects while undergoing treatment with necitumumab, they should contact their doctor right away so that they can treat or alleviate these effects.

It is not common for patients to experience a serious allergic reaction to necitumumab, but they should keep an eye out for the following, and seek emergency medical help as they may be dangerous:

  • Rashes

Dosage

Dosage for necitumumab is prescribed by the doctor and based on the condition of the patient. This dosage may be adjusted depending on the patient's response to treatment. For the medicine to give optimal benefit, patients should take care to follow their dosing schedule strictly and not miss any doses. They may wish to mark their calendars with their dosing schedule to help them remember.

Necitumumab is usually given to the patient via injection, by a trained medical professional such as a doctor or nurse. This procedure usually takes about 60 minutes, with the medicine taken intravenously. If the patient chooses to receive medication at home, they or their caregiver must discuss it with their doctor and be very familiar with the procedure before beginning such treatment.

An average dose comprises of 80 miligrams (mg) to be taken over 60 minutes, on the first and eighth day of a 3 week cycle, before gemcitabine and cisplatin are to be infused. If the patient's dose differs from this, they should not change or stop their medication. Instead they should discuss their treatment and options with their doctor.

In order to help prevent severe side effects, patients may be prescribed pre-medication such as acetaminophen or diphenhydramine.

Interactions

Drugs may interact with each other, with various supplements such as vitamins or with herbal products, to produce unwanted interactions which may affect the efficacy of the medication or elevate the risk of unwanted side effects. Prior to starting necitumumab, patients should share a list of any drugs, supplements or herbal products they are taking or have recently consumed with their doctor, in order to avoid such interactions.

The following is a list of more common drug interactions with necitumumab, and is not a complete guide. Patients should check with their doctor for a full list.

  • Gemcitabine

Certain medical conditions may affect how necitumumab works. Patients who have or have had the following conditions should notify their doctor about their medical history prior to treatment with necitumumab in order to prevent any unwanted interactions.

  • Blood clotting problems (such as DVT or pulmonary embolisms)

The consumption of certain foods may impact the effect of necitumumab as well. Alcohol and tobacco in particular have higher chances of interacting with medications. Patients should speak with their doctors about any food or drink they consume and if they may interact with their medicine.

Warnings

Prior to being treated with necitumumab, patients should read all available information from their doctor on this medication. They should address all concerns and questions before taking the medicine. They should also take care to let their doctor know of their medical history, especially if they have or have had strokes, heart disease and blood clotting problems.

During treatment, the doctor should perform regularly scheduled check-ins to ensure that the medicine is working as intended. The patient may be required to take blood tests to help with these checks.

Patients should disclose their allergies, particularly if they are allergic to necitumumab. This is because the medicine may contain certain inactive ingredients which can also lead to allergic reactions or other issues.

Necitumumab may increase patients' sensitivity to sunlight. Therefore patients should limit exposure to the sun, and refrain from the use of sunlamps or tanning booths. It is advised that patients wear protective clothing that covers as much as of the skin as possible when outdoors, and to use sunscreen liberally. If the patient becomes sunburned, or develops skin redness or blisters, they should inform their doctor.

Hypomagnesemia may occur when using necitumumab. Patients who are prone to or have had this condition should discuss this effect with their doctor.

Pregnant patients are recommended to avoid the use of this medication as it may harm unborn babies. Patients who are using necitumumab may wish to discuss reliable birth control with their doctor in order to prevent pregnancy during treatment, and for at least three months after they have stopped using this medicine. If at any point during treatment, the patient thinks that they may have become pregnant, they should inform their doctor right away.

There are insufficient studies on whether necitumumab passes into breast milk. As the medicine may carry risks for infants, it is not advised for mothers to breastfeed while on necitumumab, and for up to three months after the last dosage. If the patient has any concerns over breastfeeding, they should consult with their doctor.

Storage

Necitumumab should be stored in a cool dry place, in an optimal temperature range of 36 to 46 degrees Fahrenheit. It should not be exposed to light, or to freezing temperatures. Do not shake the medication.

This medication should be kept out of reach of children and animals.

Once expired or no longer needed, this medicine should be disposed of properly. Patients should consult their doctor or local waste management if they are unsure of how to handle medical waste.

Summary

Patients with squamous non-small cell lung cancer may be prescribed necitumumab (in conjunction with gemcitabine and cisplatin) to reduce and stop the growth of cancer cells. Dosage usually depends on the patient's condition and may be adjusted depending on how they respond to treatment.

Necitumumab may interact with certain medical conditions. Patients who have had a medical history of problems such as blood clotting, heart attacks and strokes should notify their doctor so that they can manage or prevent any worsening of the patient's health.

The medicine may also lead to some side effects such as increased sensitivity to sunlight and hypomagnesemia. Patients should talk to their doctor on how to deal with these side effects if they occur.

Necitumumab should be given only under the supervision of a doctor.

Links

1. https: //www.mayoclinic.org/drugs-supplements/necitumumab-intravenous-route/description/drg-20168762
2. http: //chemocare.com/chemotherapy/drug-info/necitumumab.aspx
3. https: //www.webmd.com/drugs/2/drug-170529/necitumumab-intravenous/details
4. https: //www.drugs.com/mtm/necitumumab.html
5. https: //reference.medscape.com/drug/portrazza-necitumumab-1000041

Necitumumab works by inhibiting the growth of squamous non-small cell lung cancer, enabling the body to destroy these cancerous cells.

  • Irritation to the eyes, such as burning, dryness or itching
  • Pain or swelling to the eye or eyelid
  • Decrease in weight
  • Diarrhea
  • Stomach upsets
  • Dry skin or itching skin
  • Swelling or irritation of the mouth
  • Headaches
  • Sudden and/or severe headaches
  • Sudden dizziness or fainting
  • Trouble with breathing, or quickened breathing
  • Coughing up blood
  • Pain in the chest, jaw or left arm
  • Pain, swelling or warmth in the groin area or in the calf
  • Confusion
  • Trouble with speaking
  • Unusual sweating
  • Feeling weak on one side of the body
  • Trouble with swallowing
  • Chills
  • Fever
  • Itching and swelling, especially of the face, throat and tongue
  • Trouble with breathing
  • Severe dizziness
  • Idelalisib
  • Palifermin
  • Thalidomide
  • High blood pressure
  • Strokes
  • Heart disease
  • Low levels of magnesium in the blood (hypomagnesemia)
  • Dermatologic toxicity
  • Ocular disorders (such as conjunctivitis)
  • Liver problems
Resources
Last Reviewed:
March 26, 2018
Last Updated:
April 05, 2018