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Encorafenib and Cetuximab A1294

Information leaflet on Encorafenib and Cetuximab  A1294

This leaflet provides information on a treatment known Encorafenib and Cetuximab.  It will explain what this is and when and how it will be given.  It will also tell you about common side effects that you may experience.  Contact telephone numbers and details of how to obtain further information on this treatment are given at the end of the leaflet.

Your ‘specialist team’ refers to your oncology team at Velindre Cancer Centre which includes doctors, specialist nurses and non-medical independent prescribers which may be a nurse or a pharmacist. 

What is Encorafenib and Cetuximab 
Encorafenib and Cetuximab is a treatment which consists of a combination of drugs which work in different ways to treat your cancer.

•     Encorafenib is an oral tablet. This is an artificially made antibody which attaches to cancer cells and stops them from growing. It is not chemotherapy.

•    Cetuximab This is an artificially made antibody which attaches itself to cancer cells and stops them from growing.  It also helps your own immune system kill the cancer cells.  It is not chemotherapy.  It is given through a drip, into a vein in your hand or arm.

Why am I having this treatment?
Your team has prescribed this treatment because it has been found to be effective in treating your type of cancer.

How often will I receive this treatment?  
For the treatment to be most effective it is given at specific time intervals.  These are known as cycles.  It is usual to have a cycle of treatment every 2 weeks. Your team will discuss with you the exact number of cycles you will receive.
How will my chemotherapy treatment be given?
The cetuximab is given through a drip into a vein in the back of your hand or arm.  Alternatively it may be suggested that a fine tube called a PICC is inserted into a large vein in your upper arm.  This line can remain in place for the whole of your treatment.  Your doctor or nurse will explain this in more detail.  

We have a leaflet that tells you more about PICC lines.  Please ask if you would like a copy. 

How do I take the Encorafenib?
Encorafenib is taken once a day.  
It is swallowed whole with water. 
It can be taken with or without food. 
It is important that the tablets are not crushed or dissolved. 
You should avoid grapefruit juice.  If you take other medications, tell your oncology team as some medications interfere with encorafenib.

What shall I do if I miss a dose?
If you have missed a dose. Do not worry.  Contact the treatment helpline for advice.  The missed dose can be taken if it is less than 12 hours until the next dose is due.  Do not take a double dose at the next time.  

What if I am sick after taking the encorafenib?
If you are sick after taking the dose, do not take an extra dose.  Take the next dose at the scheduled time. Contact the treatment helpline for advice. 

How often will I see the specialist team?
You will be reviewed by your specialist team before each cycle.  You will either see your specialist team in clinic or you will speak to them virtually. 
Your team will let you know how often they will see you.  You will have regular blood tests and we will check how you are feeling and discuss any problems you may have.  This is so we can check how the treatment is affecting you.  This appointment is usually a few days before your treatment. 

Cetuximab appointment – You should allow approximately 4-5 hours for this visit to one of the day case treatment areas.  The encorafenib will be given to you at this appointment and you will take them home.  

Can I bring relatives and friends with me? 
Currently due to the need to ensure 2m space between patients during COVID-19 we do not usually allow anyone to stay with you during your treatment. If you have any concerns about this please speak to your team before your treatment starts. We may be able to make some exceptions but we will need to be aware of this before the day of treatment. 

What are the possible side effects?
There are a number of possible side effects which can occur with this treatment.  The doctors, nurses and pharmacists can give you advice or answer any questions you may have.

Nausea and vomiting are uncommon these days as we will give you anti-sickness medicines which are usually extremely effective.  If you are sick more than once in 24 hours despite taking regular anti-sickness medicine when you are at home after your treatment, contact the treatment helpline for advice.  The telephone number is at the end of the leaflet

You may have diarrhoea.  If this occurs it is important that you drink plenty of fluids.  Medication is available to control diarrhoea.  If you have 4 or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately.  The telephone number is on page 11.

Tiredness and fatigue
This treatment may make you feel more tired than usual.  It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able.  Some people find it beneficial to take gentle exercise as well as rest.

Skin reactions
Most people (more than 80%) experience a skin reaction with cetuximab.  This is usually an acne type rash which may be dry and itchy and cause mild discomfort.  For a small number of people this reaction may be more severe.  A severe rash would affect a large part of your body, may be painful and may become infected. 

To reduce the possibility of severe skin reaction we suggest that you:

•    use non-perfumed moisturising creams on your face and upper body from the start of your treatment.  Apply the cream on your body along the same direction as the hair growth.
•    Do not wet shave, use an electric razor. 
•    avoid exposure to the sun, wear a hat and use a high factor sunscreen.
•    don’t use hot water on your skin.
•    don’t use soap if your skin is dry - use a soap alternative such as aqueous cream, or a bath emollient such as oilatum.
•    Use a gentle shampoo, such as simple shampoo.  Do not use baby shampoo.
•    try not to rub your skin vigorously - pat gently dry 
•    try to wear gloves when washing dishes.
•    wear comfortable clothes and shoes that do not rub

Your hospital doctor may prescribe antibiotic tablets to help reduce the severity of your skin rash.    

If the spots become red and angry, your doctor may give you steroid cream and antibiotic cream to apply to the area.  If the spots start to look infected, contact Velindre Cancer Centre.

This skin reaction is temporary and will resolve completely after you have finished treatment.  If you develop a severe skin reaction which is causing you pain or stopping you carrying out your normal activities, please contact Velindre Cancer Centre for advice.  The telephone number is on page 10.

Soreness to your hands and feet
You may experience mild pain, redness and swelling of your hands or feet.  If this occurs we recommend using a non perfumed cream or lotion regularly.  Please contact Velindre Cancer Centre if your hands or feet become painful.  The telephone number is at the end of the leaflet.

Nerve Damage 
You may have tingling and numbess to your hands and feet.  This is often temporary and can improve after your treatment finishes. 

Allergic type reactions
A small number of patients experience an allergic type reaction.  If this occurs you may feel hot or flushed, itchy, light-headed or generally unwell whilst receiving your cetuximab. This can be easily treated.  Please tell your nurse immediately if you experience any of the above symptoms.

•    hot and flushed 
•    itchy 
•    light headed
•    generally unwell  
•    short of breath  

This can be easily treated.  Please tell your nurse if you experience any of these symptoms.

Myalgia (pain in the muscles)
Some patients may experience myalgia which is muscle or joint pain.  This can sometimes be severe but will only last for a few days.  If you already have painkillers at home you may find they relieve the pain.  If this does not work please contact Velindre Cancer Centre.  The telephone numbers are at the end of the leaflet.

Hair loss
Most people do not lose their hair with this treatment. However some people experience some hair thinning.

We have a leaflet that tells you more about coping with hair loss.  Please ask your nurse if you would like a copy. 

Reduced red blood Cells (Anaemia) 
Encorafenib can lower your red blood cells.  We will check your blood counts regularly.  If you are anaemic we will discuss possible treatments such as a blood transfusion.  If you have any questions about this, please discuss with your team.

Other side effects

You may get headaches whilst on this treatment.  Try taking whatever painkillers you would normally take.  If these do not work please contact Velindre Cancer Centre or your GP for advice.

Very rarely encorafenib can cause a type of skin cancer which can be removed with surgery.  You may be able to continue taking the encorafenib even if this happens.

Women sometimes find that chemotherapy treatment affects their periods.  They could become heavier, lighter or even stop altogether.  

It is important you do not become pregnant or father a child whilst having this treatment, or for at least 1 month after treatment as it could damage the unborn baby.  
Breastfeeding during chemotherapy is not advised as the drugs could be passed to a baby through breast milk.

Rarely people on this treatment may experience shortness of breath.  This is more likely if you have an existing lung problem.  If you wish to discuss this further please speak to your doctor.

Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects

Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and common side-effects: for more information regarding the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy

Contact telephone numbers

Velindre Cancer Centre        029 2061 5888
Ask for the treatment helpline if you are unwell at home and need immediate attention at any time of the day or night. For example you should phone if you:
•    Are sick more than once in 24 hours
•    Have very sore hands or feet
•    Painful skin reaction
•    Diarrhea

Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines

Tenovus freephone 0808 808 1010
cancer helpline 

7 days a week 8am – 8pm for general queries on cancer

This leaflet was written by health professionals.  The information contained in this leaflet is evidence based.  It has been approved by doctors, nurses and patients.  It is reviewed and updated every 2 years.