Cetuximab and Other Anti–Epidermal Growth Factor Receptor Monoclonal Antibodies in the Treatment of Non‐Small Cell Lung Cancer

• Published in: The oncologist (Dayton, Ohio) Ohio), 2009-06, Vol.14 (6), p.601-611
• Main Authors: Gridelli, Cesare, Maione, Paolo, Ferrara, Marianna Luciana, Rossi, Antonio
• Format: Article
• Language: English
• Subjects: Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Carcinoma, Non-Small-Cell Lung - drug therapy; Cetuximab; Clinical Trials as Topic; Epidermal growth factor receptor; ErbB Receptors - antagonists & inhibitors; ErbB Receptors - genetics; In Situ Hybridization, Fluorescence; Lung Neoplasms - drug therapy; Matuzumab; Monoclonal antibodies; Mutation; NSCLC; Panitumumab; Treatment Outcome
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1634/theoncologist.2008-0153

Learning Objectives Classify clinical and molecular predictors of outcomes of anti‐EGFR monoclonal antibodies. Appraise the clinical results of anti‐EGFR monoclonal antibodies in the treatment of patients with NSCLC. Assess the clinical results of therapy with anti‐EGFR monoclonal antibodies combined with other new biologic agents in the treatment of patients with NSCLC. This article is available for continuing medical education credit at CME.TheOncologist.com Non‐small cell lung cancer (NSCLC) accounts for about 85% of all new diagnoses of lung cancer. Unfortunately, few NSCLC patients are suitable for radical treatment for curative intent. Because most patients with NSCLC have advanced disease at diagnosis, chemotherapy represents the standard of care, although, to date, a plateau has been reached with this approach. Improvements in the knowledge of tumor biology and mechanisms of oncogenesis have identified the epidermal growth factor receptor (EGFR), a member of the ErbB family, as a molecular target for NSCLC treatment. EGFR is commonly overexpressed in NSCLC and has been associated with impaired prognosis; therefore, its inhibition may lead, through the suppression of tumor proliferation, to improvement in clinical outcomes. Strategies to block EGFR include tyrosine kinase inhibitors, monoclonal antibodies, ligand‐linked toxins, and antisense approaches. This article focuses on the treatment of NSCLC with the anti‐EGFR monoclonal antibodies, including cetuximab, for which the largest amount of data in the literature exists. Recently, a phase III randomized trial performed in advanced NSCLC patients yielded a statistically significant survival advantage for patients treated with cetuximab plus chemotherapy versus chemotherapy alone. Other anti‐EGFR monoclonal antibodies, such as panitumumab, matuzumab, nimotuzumab, and ch806, are in different stages of development for the treatment of advanced NSCLC. This article focuses on the treatment of non‐small cell lung cancer with the anti–epidermal growth factor receptor monoclonal antibodies, in particular, cetuximab. The data available on panitumumab, matuzumab, nimotuzumab, and ch806, which are in different stages of development for the treatment of advanced non‐small cell lung cancer, are also examined.