Erlotinib (Tarceva®)
Erlotinib, which is commonly known as Tarceva®. It can be used to treat people with advanced non-small cell lung cancer (NSCLC). Erlotinib may also be used to treat other types of cancer as part of a research trial. Trials are in progress to find out if Tarceva® is best given alone or in combination with chemotherapy or radiotherapy.
Tarceva® belongs to a group of cancer drugs known as epidermal growth factor receptor (EGFR) inhibitors. It is a type of drug called a tyrosine kinase inhibitor. It can be used to treat some people with non-small cell lung cancer (NSCLC),
The National Institute for Clinical Excellence (NICE) gives advice on which new drugs and treatments should be available on the NHS in England and Wales. NICE has approved Tarceva® as an alternative treatment to the chemotherapy drug docetaxel for people with non-small cell lung cancer whose cancer has come back after, or not responded to at least one course of chemotherapy. Tarceva® has been approved for use in Scotland by the Scottish Medicines Consortium (SMC), an organisation similar to NICE.
Tarceva® is also being studied as a possible treatment for many other cancers, including pancreatic cancer, ovarian cancer and cancer of the head and neck. These studies are being carried out on cancers that have come back after initial treatment (recurrent), or have spread to other parts of the body (advanced or metastatic).
Epidermal growth factor receptor inhibitors
Epidermal growth factor receptor inhibitors are used to try to destroy some types of cancer cells while causing little harm to normal cells.
Structures called epidermal growth factor receptors (EGFRs) sit on the surface of many types of cancer cells. Epidermal growth factor is a protein present in the body. The receptors allow epidermal growth factor to attach to them. When these growth factors bind to the receptors, a protein called tyrosine kinase (TK) triggers chemical signals to make the cell grow and divide.
Tarceva® attaches itself to the tyrosine kinase protein and prevents the chemical signals from being produced. This may stop the cell dividing. Tarceva® therefore may be able to stop the cancer cells from growing. It works in a different way from both chemotherapy and hormonal therapy. Tests may be done to check the level of EGFR. These will tell if you are likely to benefit from Tarceva®. Testing can be done at the same time as diagnosis, or samples of cancer cells from previous biopsies or surgery may be used.
What Tarceva looks like
Tarceva® is a tablet.
How it is given
It is taken as a single dose each morning with a large glass of water, at least one hour before (or two hours after) a meal.
Possible side effects
Each person’s reaction to an anti-cancer drug is different. Some people have very few side effects, while others may experience more. If you do notice any effects which you think may be due to the drug, but which are not listed here, please discuss them with your doctor.
The side effects of Tarceva® are generally mild and some of these can be reduced with medicines. As it is still a new drug, it is too early to know everything about the possible side effects.
A rash Many people develop a rash, particularly on their face, neck, chest, back and arms. This generally starts about 8–10 days after starting treatment but usually improves after a few weeks. In most people the rash is mild. However, it is important to let your doctor know if you develop a rash.
Diarrhoea This is also quite common but, again, it is usually mild and can be controlled easily with medicine. Tell your doctor if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea. Let your doctor know if you develop any black 'tarry' looking stools.
Tiredness (fatigue) and a general feeling of weakness Fatigue is a less common side effect but is not often severe. It is important to allow yourself plenty of time to rest.
Feeling sick (nausea) and being sick (vomiting) It is quite common to feel sick but this is usually very easy to control. Some people will actually be sick. Your doctor can prescribe very effective antisickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled, or if it continues, tell your doctor. They can prescribe other anti-sickness drugs which may be more effective.
Eye problems Some people develop sore, red eyes (conjunctivitis) or dry eyes while they are being treated with Tarceva®. Your doctor can prescribe eye drops to help with this.
Sore mouth In a minority of people Tarceva® can cause a sore mouth. Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly can help. Tell your nurse or doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.
Additional information
Some other medicines can be harmful to take when you are having Tarceva®. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs or vitamins.
Contraception It is not advisable to become pregnant or father a child while taking Tarceva®, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. It is important to discuss this with your doctor.
Smoking This may make Tarceva® work less effectively.
Things to remember about Tarceva tablets
- Keep the tablets in a safe place where children cannot reach them, as Tarceva® could harm them.
- Store them in their original container.
- If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away.
- If you are sick just after taking the tablets, let your doctor know, as you may need to take another dose. Do not take another tablet without first telling your doctor.
- If you forget to take a tablet, do not take a double dose. Tell your doctor and keep to your regular dose schedule.
