Tarceva

Generic Name: Erlotinib

Drug Type:

Tarceva is a targeted therapy. Tarceva is classified as a epidermal growth factor receptor (EGFR) inhibitor - protein-tyrosine kinase inhibitor.  (For more detail, see "How Tarceva Works," below.)

What Tarceva Is Used For:

• Treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC).
• Treatment of patients with locally advanced, unresectable or metastatic pancreatic cancer.

Note:  If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Tarceva Is Given:

• Tarceva is given in tablet form to be taken by mouth at least one hour before or two hours after eating.  The tablets are supplied in 25mg, 100mg and 150mg strengths.
• The amount of Tarceva that you will receive depends on many factors, including your general health or other health problems, and the type of cancer or condition being treated.  Your doctor will determine your dose and schedule.

Side Effects:

Important things to remember about Tarceva side effects:

• Most people do not experience all of the Tarceva side effects listed.
• Tarceva side effects are often predictable in terms of their onset and duration.
• Tarceva side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent Tarceva side effects.

The following Tarceva side effects are common (occurring in greater than 30%) for patients taking Tarceva:

• Rash
• Diarrhea
• Poor appetite
• Fatigue
• Shortness of breath
• Cough
• Nausea and vomiting

These Tarceva side effects are less common side effects (occurring in about 10-29%) of patients receiving Tarceva:

• Infection
• Mouth sores
• Itching
• Dry skin
• Eye irritation
• Abdominal pain

Not all Tarceva side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

• Onset or worsening of unexplained shortness of breath or cough.

The following symptoms require medical attention, but are not an emergency.  Contact your health care provider within 24 hours of noticing any of the following:

• Nausea (interferes with ability to eat and unrelieved with prescribed medication).
• Vomiting (vomiting more than 4-5 times in a 24 hour period).
• Diarrhea (4-6 episodes in a 24-hour period).
• Extreme fatigue (unable to carry on self-care activities).
• Mouth sores (painful redness, swelling or ulcers).
• Eye irritation.
• Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

• Before starting Tarceva treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).  Certain medications can interfere with the levels/effects of Tarceva.  It is important your oncologist is aware of all medications.  Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
• Do not receive any kind of immunization or vaccination without your doctor's approval while taking Tarceva.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Tarceva may be hazardous to the fetus.  Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.)
• For both men and women: Do not conceive a child (get pregnant) while taking Tarceva. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking Tarceva.

Self-Care Tips:

• Tarceva should be taken on an empty stomach, 1 hour before or 2 hours after eating.
• Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• You may be at risk of infection report fever or any other signs of infection immediately to your health care provider.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• Avoid sun exposure.  Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
• Get plenty of rest.
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking Tarceva, to monitor side effects and check your response to therapy.  Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.   

How Tarceva Works:

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells.  To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that divide rapidly.  Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects. 

Targeted therapy is about identifying other features of cancer cells.  Scientists look for specific differences in the cancer cells and the normal cells.  This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects.  Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells. 

There are different types of targeted therapies, defined in three broad categories.  Some targeted therapies focus on the internal components and function of the cancer cell.  These use small molecules that can get into the cell and disrupt the function of the cells, causing them to die.  There are several types of targeted therapy that focus on the inner parts of the cells.   The second variety target receptors that are on the outside or surface of the cell.   This form of targeted treatment includes the monoclonal antibodies.  Finally, antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cancer cells, ultimately causing the cells to starve and die.

Tarceva is designed to block tumor cell growth by targeting a protein EGFR (epidermal growth factor) that is present on the surface of some cancer cells and some normal cells.  Tarceva inhibits an enzyme within the cell (tyrosine kinase) that is associated with EGFR, however, the specifics of how this inhibition functions is not fully understood.

Research continues to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer. 

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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