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Biologics are medicinal products which are created by biologic processes from animal products and other living sources instead of being chemically manufactured. Biologics are used to prevent, diagnose or treat disease. The idea is to attack a part of cancer cells that is not also found in normal cells. One effect is to reduce side effects which are common with chemotherapy.

Biological therapy and chemotherapy are both treatments that fight cancer. While they may seem alike, they work in different ways. Biological therapy helps your immune system fight cancer. Chemotherapy attacks the cancer cells directly. 

The side effects of biological therapy depend on the type of treatment. Often, these treatments cause flu-like symptoms such as chills, fever, muscle aches, weakness, loss of appetite, nausea, vomiting, and diarrhea. Some patients develop a rash, and some bleed or bruise easily. These side effects are usually short-term and they gradually go away after treatment stops.

Other sections of this article cover:


  • Keep in mind that your primary doctor is also part of your medical team. Ask your specialists to keep him or her up-to-date. Don't skip your regular appointments.
  • If you are treated in a hospital other than your local hospital,  get a copy of your medical records for the local hospital where you will do the follow up. You are legally entitled to a copy. There may be a charge. For additional information, click here.

Biologics Common To Colorectal Cancer

Biologics common to colorectal cancer are:

  • Bevacizumab (Avastin)
    • Bevacizumab is a monoclonal antibody. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. 
      • Antibodies are compounds which are produced by our own immune system in self-defense against foreign substances such as bacteria, viruses or toxins. 
      • Monoclonal antibodies are similar to the antibodies that the human immune system uses to fight off bacteria and viruses, but they are "custom-designed” in a laboratory to target specific cell types.
      • Monoclonal antibodies are generally used in combination with chemotherapy drugs. 
    • Bevacizumab targets vascular endothelial growth factor (VEGF). VEGF is responsible for blood vessel growth in tumor cells.
    • Bevacizumab is given intraveneously over a period of time ranging from 30 minutes to 2 hours.
    • Common side effects include high blood pressure, blood clots, low white blood cell counts, headaches, loss of appetite, mouth sores, and diarrhea. While less likely, Bevacizumab can also cause bleeding, holes forming in the colon and slow wound healing.
  • Cetuximab (Erbitux) –
    • Cetuximab is a monoclonal antibody that attacks the epidermal growth factor receptor (EGFR).  (See above for information about monoclonal antibodies).
    • Cetuximab is given intravenously through an iv.
    • Reactions to the first infusion are particularly watched because Cetuximab can cause breathing problems and low blood pressure. Other side effects include dry skin, fatigue, fever, constipation and an acne-like rash.
    • For more information, click here.
  • Panitumumab (Vectibix) is similar to the above treatments but is fully human so there are less side-effects.


  • Panitumumab and cetuximab require a test for a specific gene called kras.  The testing can be done on either the primary tumor or a site to which the cancer has spread (metasticized).  If your tumor is kras wildtype or normal you can get either of these biologics.  If your gene is mutated you are not eligible to receive either of these biologics.
  • For information about dealing with common side effects, click here

Questions To Ask About Biologics

  • What drugs will I have? 
    • What will they do?
    • How?
  • When will treatment start? When will it end? 
  • How often will I have treatments?
    • Treatment schedules vary. Biological therapy may be given once a day or a couple of times a day. Others are given less often--sometimes once a week, or perhaps just once every month or two. 
    • Your doctor will tell you how often you will get your treatment and how long you will need to be on it.
  • Where will I go for treatment? 
    • The biologics used to treat colorectal cancer are currently given through an IV, and you must go to the hospital or clinic to get  the infusion. If this is the case, find out how long you will need to stay at the hospital or clinic.
  • Will I be able to drive home after treatment?
  • How will we know the treatment is working?
  • What side effects should I expect? Just like other forms of cancer treatment, biological therapy sometimes causes side effects. Side effects can include:
    • Rashes on the face and body with some of the EGFR treatments
    • Flu-like symptoms such as fever, chills, nausea, vomiting, loss of appetite, fatigue, bone pain, and muscle aches. (For information about how to cope with these side effects, see the documents in "To Learn More")
  • Which side effects should I tell you about?
  • Will there be long-term effects?
  • What can I do to take care of myself during treatment?
  • Should I change any of my normal activities or eating habits ?
  • How much will the treatment cost? Talk with your nurse, social worker, or doctor about the cost of your treatment. Make sure to ask if your insurance company pays for biological therapy.

More Information About Biologics

After you talk with your doctor or nurse, you may also want to do your own "homework" about the treatments you are on. Here are some ways to learn more:
  • Visit the MEDLINEplus Web site sponsored by the National Institutes of Health at offsite link. This Web site has a lot of information about many types of cancer drugs, including biological therapy. 
  • Call the Cancer Information Service (CIS) at 1-800-4-CANCER (1-800-422- 6237). Sponsored by the National Cancer Institute (NCI), the CIS has information about cancer and its treatments.
  • To learn how to do your own medical research, click here.