Panitumumab is a type of targeted cancer drug called a monoclonal antibody. It’s also known by its brand name, Vectibix. You might have it as a treatment for bowel cancer that has spread to other areas of the body (advanced).
Panitumumab is sometimes combined with other chemotherapy treatments such as:
How panitumumab works
Panitumumab works by blocking signals that tell cancer cells to divide and grow. It attaches to a specific protein called epidermal growth factor receptor (EGFR) found on the surface of some cancer cells.
Panitumumab only works on bowel cancers that have a normal Ras gene. You will have tests to check that your bowel cancer has the normal version of this gene.
How you have panitumumab
You have panitumumab as a drip into a vein (intravenously).
You have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
- central line
- PICC line
If you don't have a central line
You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
When you have panitumumab
You have panitumumab every 2 weeks. The first treatment takes about 60 to 90 minutes. If you don't have any problems treatments after that take about 30 to 60 minutes.
You usually have panitumumab for as long as it is helping you and the side effects aren't too bad.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.
When to contact your team
Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
Common side effects
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Nearly everyone who has panitumumab will have a skin reaction. The reaction usually starts about 10 days after the start of treatment and gets better within a month of finishing treatment.
You might notice skin changes, such as dryness, itching and rashes similar to acne on your face, neck and trunk.
Tell your doctor if you have any rashes or itching. Don't go swimming if you have a rash because the chlorine in the water can make it worse.
If your skin gets dry or itchy, smoothing in unperfumed moisturising cream may help. Check with your doctor or nurse before using any creams or lotions.
Your skin is more sensitive to sunlight during your treatment and for several months afterwards. You need to cover up and stay in the shade. Wear a high factor sun block if you’re going out in the sun. Sunlight can make skin reactions worse.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Mouth sores and ulcers can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids, avoid acidic foods such as oranges, lemons and grapefruits, and chew gum to keep the mouth moist. Tell your doctor or nurse if you have ulcers.
Your nails might become infected. Tell your doctor or nurse if this happens.
Tiredness and weakness
Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
This affects about 4 out of 10 people (40%).
Diarrhoea and constipation
Tell your doctor or nurse if you have diarrhoea or constipation. They can give you medicine to help.
Diarrhoea affects about half of everyone who receives panitumumab. Constipation happens in about 2 out of 10 people (20%).
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
You might have eye problems, such as conjunctivitis.
Let your doctor or nurse know if you have any problems with your eyes. They can give you eye drops to help.
Loss of appetite and weight loss
You might not feel like eating and may lose weight. It is important to eat as much as you can. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
Low levels of minerals in your blood
You might have changes in levels of minerals and salts in your blood, such as low magnesium and potassium.
You have regular blood tests during treatment to check this.
You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
Tummy (abdominal) pain
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
This affects 2 out of 10 people (20%).
Swollen hands and feet
Swelling of hands and feet is due to fluid build up. This is called oedema. Let your doctor or nurse know if you have any swelling.
High temperature (fever)
If you get a high temperature, let your health care team know straight away. Ask them if you can take paracetamol to help lower your temperature.
This can happen in about 2 out of 10 people (20%).
You might have back pain. Speak to your doctor if this is a problem for you. They can prescribe medicine to help.
It can help to change a few things about how you try to sleep. Try to go to bed and get up at the same time each day and spend some time relaxing before you go to bed. Some light exercise each day may also help.
Cough and difficulty breathing
You may have difficulty breathing with wheezing and coughing. Let your doctor or nurse know straight away if this happens.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- increased risk of getting an infection due to low white blood cells
- an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness
- blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms
- chest, arm and leg pain
- feeling anxious
- eye problems such as watery, itchy, dry eyes. Red or swollen eyelids
- hair changes - longer or thicker eyelashes - increased hair on your face or body
- soreness, redness and peeling hands and feet
- nail changes that can cause your nails to break easily
- sweating more than usual
- indigestion and heartburn
- high blood sugar levels
- changes to your blood pressure causing it to go too high or too low
- a fast heart rate
- redness (flushing) of the skin
- dry mouth
Rare side effects
These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include
- sore and swelling of the eyelids
- dry, chapped lips
- loosening of the nails
- ulcer and tenderness on the front part of your eye (cornea)
- a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know?
Contact lenses and eye problems
Panitumumab can cause eye problems such as infection, dry eyes and ulcers on the front part of your eye. Let your doctor know if you wear contact lenses or are prone to eye problems.
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 2 months afterwards.
Talk to your doctor or nurse about effective contraception before starting treatment.
Loss of fertility
You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
Do not breastfeed during this treatment and for at least 2 months afterwards. The drug may come through in the breast milk.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.