Side effects of targeted therapies

Those having treatment with trastuzumab (Herceptin) may experience the following side effects:

• Alopecia
• Confusion
• Eye problems (e.g. producing more tears, swollen runny eyes, conjunctivitis)
• Fatigue
• Frequent infections or flu and/or cold symptoms
• Hand-foot syndrome
• Headache or dizziness
• Hot flushes
• Increased cough
• Insomnia
• Joint or muscle pain or weakness
• Loss of appetite
• Mouth ulcers
• Nail problems
• Nausea or vomiting
• Neutropenia
• Nose bleeds or runny/blocked nose
• Shortness of breath.

There is also a risk of an infusion reaction, especially with the first dose. Patients may experience a number of side effects from an infusion reaction, including fever and chills and muscle aches.

Trastuzumab can also damage the heart and heart problems are more common in patients who have received prior treatment with anthracycline chemotherapy (e.g. Adriamycin). Patients on trastuzumab will be monitored before, during and after treatment to determine the effect, if any, on the heart. They will also undergo scans before and during treatment to ensure the heart is functioning properly.

For more information on side effects, see the Medsafe consumer information.

Common side effects of pertuzumab (Perjeta) include:

• Diarrhoea or constipation
• Eye problems (e.g. producing more tears)
• Fatigue
• Frequent infections or cold and/or flu-like symptoms
• Hot flushes
• Dyspepsia
• Insomnia
• Joint or muscle pain or weakness
• Loss of appetite or altered taste
• Mucositis
• Nail problems
• Nausea
• Neutropenia
• Nose bleeds
• Peripheral neuropathy
• Rash
• Shortness of breath.

As with trastuzumab, pertuzumab can affect the heart. Patients will be monitored before, during and after treatment to determine any adverse effects on the heart.

For more information on side effects, see the Medsafe consumer information.

Patients treated with trastuzumab ematansine may experience the following side effects:

• Altered or loss of taste
• Diarrhoea or constipation
• Dizziness
• Dry mouth
• Eye problems (e.g. producing more tears, swollen runny eyes, conjunctivitis)
• Fatigue
• Frequent infections or cold and/or flu-like symptoms
• Dyspepsia
• Insomnia
• Joint or muscle pain or weakness
• Mouth ulcers
• Neutropenia
• Nose bleeds
• Vomiting.

For more information on side effects, see the Medsafe consumer information.

Patients may experience the following side effects while being treated with lapatinib:

• Alopecia
• Anaemia
• Back pain
• Diarrhoea or constipation
• Fatigue
• Insomnia
• Itching
• Irregular heartbeat and shortness of breast
• Hand-foot syndrome
• Headache
• Leukopenia
• Loss of appetite
• Mucositis
• Muscle pain
• Nail disorders
• Nose bleeds
• Palmar-planar erythrodysesthesia
• Peripheral neuropathy
• Skin reactions (e.g. blisters, dry skin, peeling skin, rash).

For more information on side effects, see the Medsafe consumer information.

Bisphosphonates (e.g. zoledronic acid, riedronate) can cause osteonecrosis of the jaw. Patients should have a dental examination with preventive dentistry prior to treatment with bisphosphonates.

Patients treated with palbociclib may experience the following side effects:

• Alopecia
• Altered taste
• Anaemia
• Decreased appetite
• Diarrhoea
• Eye problems (e.g. blurred vision, producing more tears, dry eyes)
• Fatigue
• Increased ALT and AST levels
• Infection or fever
• Interstitial lung disorder/pneumonitis
• Leukopenia
• Mouth ulcers
• Nausea and vomiting
• Neutropenia and febrile neutropenia
• Nose bleeds
• Skin reactions (e.g. dry skin, rash)
• Thrombocytopenia.

For more information on side effects, see the Medsafe consumer information.