Tarceva Side Effects

woman with skin rash on arm

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Tarceva (erlotinib) is a targeted cancer drug prescribed to treat advanced-stage non-small cell lung cancer and advanced pancreatic cancer (in combination with gemcitabine chemotherapy). It is an oral medication and is prescribed in tablet form.

This medication is believed to work by targeting epidermal growth factor receptor (EGFR), a protein that fuels cancer cell growth.

Common Side Effects

The most common side effects caused by Tarceva include rash, diarrhea, loss of appetite, fatigue, shortness of breath, cough, infection, nausea, and vomiting. This medication is not recommended for pregnant women.

Be sure to discuss any of these symptoms with your doctor if they occur.

Rash

Rashes related to Tarceva usually appear within two weeks of starting treatment. Those taking Tarceva in combination with gemcitabine can develop a rash anytime during treatment.

Tarceva rashes look similar to acne or dry skin and can appear on the body and face. It most often appears from the waist up. For some, the rash can be itchy or feel like a minor sunburn. Not all people will develop a skin rash from Tarceva. Those who develop rash often report it subsiding during treatment or as the dosage is lowered.

Rash and Drug Efficacy

Interestingly, studies have shown that people who develop a rash when using Tarceva or Tarceva with gemcitabine tend to have better outcomes than those who do not develop a rash when using these drugs. It is important to keep in mind that the drug is not completely ineffective in those who do not develop a rash—but those who develop a rash seem to be more likely to benefit.

When to Call Your Doctor

While rashes are associated with a better effect of this drug, it is still very important that you let your doctor know if you begin to develop a rash. Rashes can lead to infections or scabbing, and some rashes are serious.

Do not apply any medications to treat your rash, including over the counter or herbal remedies until you consult with your doctor first. Your doctor may prescribe a topical antibiotic or another ointment to help with the rash. Some people may benefit from temporarily stopping treatment, even if it just for a few days.

Severe blistering skin rashes have occurred during clinical trials. This is an extremely rare side effect that has been compared to Stevens-Johnson syndrome, a potentially fatal condition that is caused by a severe allergic reaction to a medication.

Diarrhea

Another common side effect of Tarceva is diarrhea. This complication may result in malnutrition or dehydration, so it is important that you are treated for it.

While there are many over-the-counter anti-diarrhea medications, it is important to consult with your doctor before taking anything. Your doctor may have specific recommendations for you based on your overall health and will advise you regarding the right medication and dose. If your diarrhea worsens or cannot be controlled with the recommended medications, follow up with your doctor.

Rare Side Effects

In clinical trials, these rare side effects of Tarceva were observed:

  • Intestinal perforations
  • Lung disease
  • Kidney or liver damage
  • Damage to the eyes
  • Heart attack
  • Bleeding

Be sure to provide your doctor with a thorough health history that includes all over-the-counter medications, herbal remedies, and prescription drugs you take. Certain conditions and other drugs may increase your risk of developing uncommon side effects.

When to Call Your Doctor

When you are being treated for advanced cancer, you are likely to see your doctors frequently. However, it is important that you do not assume that they are noticing side effects. If you have symptoms, be sure to tell members of your medical team when you see them, or call your doctor if these symptoms develop when you are at home.

Side effects to watch for include:

  • A cough
  • Abdominal pain or discomfort
  • Shortness of breath
  • Eye irritation
  • A new skin rash or a worsening rash
  • A fever
  • Vomiting or diarrhea
  • Weight loss
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Article Sources

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  1. FDA. Tarceva, drug label. Updated 2010.

  2. Fabbrocini G, Panariello L, Caro G, Cacciapuoti S. Acneiform rash induced by EGFR inhibitors: review of the literature and new insightsSkin Appendage Disord. 2015;1(1):31–37. doi:10.1159/000371821

  3. Clabbers JMK, Boers-Doets CB, Gelderblom H, et al. Xerosis and pruritus as major EGFRI-associated adverse eventsSupport Care Cancer. 2016;24(2):513–521. doi:10.1007/s00520-015-2781-y

  4. Haas M, Siveke JT, Schenk M, et al. Efficacy of gemcitabine plus erlotinib in rash-positive patients with metastatic pancreatic cancer selected according to eligibility for FOLFIRINOX: A prospective phase II study of the 'Arbeitsgemeinschaft Internistische Onkologie'. Eur J Cancer. 2018;94:95-103. doi:10.1016/j.ejca.2018.02.008

Additional Reading

  • Erlotinib, MedlinePlus, U.S. National Library of Medicine, revised 07/01/2009.
  • Wacker B, Nagrani T, Weinberg J, et al. Correlation between development of rash and efficacy in patients treated with the epidermal growth factor receptor tyrosine kinase inhibitor erlotinib in two large phase III studies. Clin Cancer Res. 2007;13(13):3913-3921.