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Drugs of interest to pathologists

Drugs related to surgical pathology

Panitumumab


Author: Him G. Kwee, M.D. (see Reviewers/Authors page)
Revised: 31 March 2012, last major update January 2012
Copyright: (c) 2012, PathologyOutlines.com, Inc.

General
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● A fully human monoclonal antibody directed against EGFR (epidermal growth factor receptor)

Trade name
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● Vectibix®

Clinical information
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Approved by US Food and Drug Administration:
● As monotherapy for metastatic colorectal carcinoma after disease progression on or following standard fluoropyrimidine, oxaliplatin and irinotecan chemotherapy regimens (National Cancer Institute Drug Information, Panitumumab, August 24, 2011)
● Cost: approximately $3000 per 2 weeks treatment in 2007, $950 for 100mg/5ml Solution, 5ml Vial at drugstore.com in March 2012
● Side effects: infusion reactions, dermatologic toxicity which can be fatal, acne-like rash, skin photosensitivity, pulmonary fibrosis, eye toxicity (keratitis, ulcerative keratitis), hypomagnesemia and hypocalcemia (National Cancer Institute Drug Information, Panitumumab, August 24, 2011)

Molecular pathology-theory
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● Like cetuximab (Erbitux), panitumumab inhibits the extracellular domain of EGFR, but cetuximab is a chimeric (human / mouse) antibody and panitumumab is a full human monoclonal antibody
● With cetuximab, there is a high incidence of IgE mediated anaphylactic reactions, but these reactions have not been seen with panitumumab (BMC Clin Pharmacol 2011;11:17)
● Cetuximab is an IgG1 antibody, but panitumumab is an IgG2 antibody; IgG1 can activate the complement pathway and mediate antibody-dependent cellular cytotoxicity (Wikipedia)
● KRAS mutational analysis must be performed before treatment with cetuximab or panitumumab; these drugs cannot be used if there is a Kras mutation in codons 12 or 13 (Arch Pathol Lab Med 2012;136:26)

End of Drugs > Drugs related to surgical pathology > Panitumumab


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