Interactions between cetuximab and Cisplatin (cisplatin)
cisplatin and cetuximab (Moderate Drug-Drug)
MONITOR: The safety of cetuximab in combination with cisplatin and radiation therapy has not been established. Death and serious cardiotoxicity were observed in a single-arm trial with cetuximab, cisplatin (100 mg/m2), and delayed, accelerated (concomitant boost) fractionation radiation therapy conducted in patients with locally advanced squamous cell carcinoma of the head and neck. Two of 21 patients died, one from pneumonia and one from an unknown cause. Four patients discontinued treatment due to adverse events, two of which were cardiac events (myocardial infarction in one and arrhythmia, diminished cardiac output, and hypotension in the other). An integrated analysis across all clinical studies demonstrated that cisplatin does not affect the pharmacokinetics of cetuximab.
MANAGEMENT: Until more data are available, caution is advised if cetuximab is used in combination with cisplatin and radiation. Patients should be monitored closely for cardiotoxicity, and therapy discontinued if necessary.
