Portrazza® is approved as initial treatment in combination with chemotherapy drugs gemcitabine and cisplatin for patients with metastatic (spread to distant parts of the body) squamous non-small cell lung cancer (NSCLC). Necitumumab is a targeted therapy that is classified as a monoclonal antibody. Antibodies are a normal part of the immune system that attach to antigens (such as germs) to mark them for destruction by the immune system. Monoclonal antibodies are created in a laboratory to attach to specific antigens on the surface of cancer cells. Necitumumab is a monoclonal antibody that attaches to EGFR (epidermal growth factor receptors) and is an EGFR antagonist (blocks the EGFR pathway to inhibit cancer growth).1,2
EGFR is one of several receptor tyrosine kinases (RTKs). RTKs are cell-surface receptors that partner with ligands, proteins that activate the receptor to cause a specific action in the cell. In its normal capacity, EGFR triggers cell growth and division. When there is a mutation to the EGFR gene, such as is found in many cancer cells, the malignant (cancerous) cells are activated to divide, grow faster, and survive.3-5
Necitumumab is given as an infusion through an IV (intravenous) line. The dosage is determined by several factors, including the patient’s general health and ongoing response to treatment.2
Side effects of necitumumab
Necitumumab may cause side effects, and in some cases, these side effects can be severe. Any side effects should be reported to a health care professional. Side effects experienced in greater than approximately 30 percent of patients receiving necitumumab include skin reactions (rash, dry skin, itching, and/or redness) and lowered amounts of magnesium, calcium, and phosphorous in the blood. Less common side effects experienced in approximately 10-29 percent of patients receiving necitumumab include vomiting, diarrhea, acne, weight loss, mouth sores, coughing up blood, and lowered amounts of potassium in the blood. Rarely, necitumumab can cause severe side effects, including serious heart and lung events. Patients taking necitumumab should seek medical care immediately if they experience any of the following symptoms: fever of 100.4°F or higher, mood changes, confusion, muscle pain or weakness, a heartbeat that feels abnormal, seizures, not feeling hungry, bad stomach upset, weakness on one side of the body, difficulty speaking or thinking, changes in balance, blurred eyesight, dizziness, passing out, or signs of a blood clot, such as chest pain, pressure, coughing up blood, shortness of breath, or swelling, warmth, numbness or pain in a leg or arm.2 This is not an exhaustive list of all potential side effects of necitumumab. Talk to your healthcare provider or pharmacist for further information.
Patients receiving necitumumab should talk to their doctor about any other medications (prescription and over-the-counter), herbal remedies, and any supplements they are taking, as well as any other health conditions. Patients who are pregnant or may become pregnant during treatment should discuss their condition with their doctor prior to starting necitumumab, as it may be hazardous to the fetus. Females who can become pregnant should utilize effective birth control (patients should discuss appropriate birth control methods with their doctor) throughout necitumumab treatment and for three months following the last dose of necitumumab. It is not known whether necitumumab passes into breast milk, and patients should not breastfeed while receiving necitumumab treatment and for three months following the last dose of necitumumab. Patients should talk to their doctor if they have any questions, or if they have questions regarding their necitumumab regimen.2