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Panitumumab

    DEA Class; Rx

    Common Brand Names; Vectibix

    • Antineoplastics, Monoclonal Antibody; 
    • Antineoplastics, EGFR Inhibitor

    Anti-EGFR monoclonal antibody
    Used for wild-type RAS metastatic colorectal cancer as monotherapy or in combination with chemotherapy
    Dermatologic adverse reactions and severe infusion reactions may occur

    Indicated for both KRAS and NRAS as determined by an FDA-approved test for this use (eg, next-generation sequencing [NGS] kit)

    Combination therapy: With FOLFOX, as first-line treatment

    Monotherapy: Following disease progression after prior treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy

    • Erythema (65%)
    • Acneiform dermatitis (57%)
    • Pruritus (57%)
    • Hypomagnesemia (39%)
    • Fatigue (26%)
    • Abdominal pain (25%)
    • Paronychia (25%)
    • Skin exfoliation (25%)
    • Nausea (23%)
    • Rash (22%)
    • Constipation (21%)
    • Diarrhea (21%)
    • Vomiting (21%)
    • Skin fissures (20%)
    • Cough (14%)
    • Dermatologic toxicity, Grade 3 and 4 (14% )
    • Acne (13%)
    • Peripheral edema (12%)

    Increased tumor progression, increased mortality, or lack of benefit in patients with RAS-mutant mCRC; determine RAS-mutant tumor status in an experienced laboratory using an FDA-approved test before treatment

    Monitor patients who develop dermatologic toxicities while receiving panitumumab for the development of inflammatory or infectious sequelae; limit sun exposure

    Panitumumab is not indicated for use in combination with chemotherapy due to increase in mortality or toxicity

    Permanently discontinue in patients developing pulmonary fibrosis/interstitial lung disease

    Monitor electrolytes and institute appropriate treatment if needed

    Terminate the infusion for severe infusion reactions

    Ocular toxicities reported; monitor for keratitis or ulcerative keratitis; interrupt or discontinue for acute or worsening keratitis

    Discontinue permanently if patient develops interstitial lung disease, pneumonitis, or lung infiltrates

    Avoid pregnancy

    Not indicated for treatment of patients with colorectal cancer that harbor somatic RAS mutations in exon 2 (codons 12 and 13), exon 3 (codons 59 and 61), and exon 4 (codons 117 and 146) of either KRAS or NRAS (RAS)

    Progressively decreasing serum magnesium levels leading to severe (grade 3-4) hypomagnesemia reported; monitor patients for hypomagnesemia and hypocalcemia prior to initiating treatment, periodically during treatment, and for up to 8 weeks after completion of treatment; other electrolyte disturbances, including hypokalemia, have also been observed; replete magnesium and other electrolytes as appropriate

    Based on data from animal studies and mechanism of action; therapy can cause fetal harm when administered to pregnant women

    There are no data on presence of drug in human milk or effects of panitumumab on breastfed infant or on milk production

    Adults

    6 mg/kg IV every 2 weeks.

    Geriatric

    6 mg/kg IV every 2 weeks.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Panitumumab

    injectable solution

    • 100mg/5mL