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NCCN Guidelines for Patients



Rectal Cancer, Version 1.2017


Overview of cancer treatments



Panitumumab is the same type of drug as cetuximab.

However, it does somewhat differ from cetuximab

in its structure. It works much like cetuximab by

attaching to EGFRs and attracting immune cells.

Panitumumab is given by IV infusion over 1 hour

every other week. It may be given with or without


Panitumumab rarely causes infusional reactions.

Common side effects are skin rash and swelling

around the nails. You may get diarrhea, nausea,

and feel tired. Blood magnesium levels may drop.

Rare but serious side effects include lung and eye



The immune system is your body’s natural defense

against infection and disease. The immune system

includes many chemicals and proteins. These

chemicals and proteins are made naturally in your

body. Immunotherapy increases the activity of your

immune system. By doing so, it improves your body’s

ability to find and destroy cancer cells.

PD-1 inhibitors

T-cells are part of your immune system. One job of

T-cells is to attack cancer cells. PD-L1 is a molecule

that can stop T-cells from doing their job.

Rectal cancers that have dMMR or MSI-H also have

PD-L1 on the cells’ surface. PD-L1 attaches to PD-1

on T-cells. This stops T-cells from attacking cancer


Figure 14

EGFR targeted therapy

Some rectal cancers consist of

cells with too many or overactive

EGFRs. EGFRs trigger growth

signals with cancer cells.

Cetuximab and panitumumab

block EGF from attaching to

EGFR and turning it on.

cancer cell





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