Targeted drug therapy is the use of medicines that target or are directed at proteins on cancer cells that help them grow, spread, and live longer. These drugs work to destroy cancer cells or slow their growth. Their side effects are different from chemotherapy (sometimes less severe) and many are taken as a pill.
Targeted drug therapy is used to treat many kinds of cancer, but this type of drug has not been well studied for treating most kinds of nasal cavity and paranasal sinus cancers since they are so rare. Some targeted drugs are used to treat melanomas in these areas. They can be used for nasal cavity and paranasal sinus cancers because of information from studies done in more common head and neck cancer types.
Some targeted drugs, for example, monoclonal antibodies, work in more than one way to control cancer cells and may also be considered immunotherapy because they boost the immune system.
Epidermal growth factor receptor (EGFR) is a protein that helps cancer cells grow. Drugs that target EGFR can be used to treat some advanced squamous cell cancers of the head and neck.
Cetuximab (Erbitux) is a monoclonal antibody, which is a man-made version of an immune system protein that targets EGFR, a protein on the surface of certain cells that helps them grow and divide. Nasal cavity and paranasal sinus cancer cells often have more than normal amounts of EGFR. By blocking EGFR, cetuximab can slow or stop cancer cell growth.
Cetuximab may be used to treat more advanced cancers, such as those that have spread or come back after treatment. It may be combined with radiation and/or chemo drugs, such as cisplatin and 5-FU, or it may be used alone.
Cetuximab is given by infusion into a vein (IV), either once a week or every other week.
The most common side effects of cetuximab are skin problems such as an acne-like rash on the face and chest during treatment, which in some cases can lead to infections. An antibiotic cream or ointment may be needed to help control the skin rash and related infections. Developing this rash might suggest the cancer is responding to treatment.
Other side effects might include headache, tiredness, fever, nausea, and diarrhea.
A rare but serious side effect of cetuximab is an allergic reaction during the infusion, especially the first infusion, which could cause serious breathing problems and low blood pressure. You'll be given medicine before treatment to help prevent this.
Talk to your cancer care team about the side effects to watch for and what can be done to help prevent or treat them.
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Kashat L, Le CH, Chiu AG. The Role of Targeted Therapy in the Management of Sinonasal Malignancies. Otolaryngol Clin North Am. 2017;50(2):443-455.
National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. V.2.2020 – June 09, 2020. Accessed at www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf on November 09, 2020.
Susman E. Rash correlates with tumour response after cetuximab. Lancet Oncol. 2004;5(11):647. doi:10.1016/s1470-2045(04)01627-4.
Last Revised: April 19, 2021