Role of cetuximab in first-line treatment of metastatic colorectal cancer.
The treatment of metastatic colorectal cancer (mCRC) has evolved considerably in the last decade, currently allowing most mCRC patients to live more than two years. Monoclonal antibodies targeting the epidermal growth factor receptor (EGFR) and vascular endothelial growth factor play an important role in the current treatment of these patients. However, only antibodies directed against EGFR have a predictive marker of response, which is the mutation status of v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS). Cetuximab has been shown to be effective in patients with KRAS wild-type mCRC. The CRYSTAL study showed that adding cetuximab to FOLFIRI (regimen of irinotecan, infusional fluorouracil and leucovorin) significantly improved results in the first-line treatment of KRAS wild-type mCRC. However, results that evaluate the efficacy of cetuximab in combination with oxaliplatin-based chemotherapy in this setting are contradictory. On the other hand, recent advances in the management of colorectal liver metastases have improved survival in these patients. Adding cetuximab to standard chemotherapy increases the response rate in patients with wild-type KRAS and can thus increase the resectability rate of liver metastases in this group of patients. In this paper we review the different studies assessing the efficacy of cetuximab in the first-line treatment of mCRC.
Miguel Jhonatan Sotelo, Beatriz García-Paredes, Carlos Aguado, Javier Sastre, Eduardo Díaz-Rubio, Center affiliate to the "Red Temática de Investigación Cooperativa (RD12/0036/006)", Instituto Carlos III, Spanish Ministry of Economy and Competitivity. Oncology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Miguel Jhonatan
MJ
Sotelo
Miguel Jhonatan Sotelo, Beatriz García-Paredes, Carlos Aguado, Javier Sastre, Eduardo Díaz-Rubio, Center affiliate to the "Red Temática de Investigación Cooperativa (RD12/0036/006)", Instituto Carlos III, Spanish Ministry of Economy and Competitivity. Oncology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Beatriz
B
García-Paredes
Miguel Jhonatan Sotelo, Beatriz García-Paredes, Carlos Aguado, Javier Sastre, Eduardo Díaz-Rubio, Center affiliate to the "Red Temática de Investigación Cooperativa (RD12/0036/006)", Instituto Carlos III, Spanish Ministry of Economy and Competitivity. Oncology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Carlos
C
Aguado
Miguel Jhonatan Sotelo, Beatriz García-Paredes, Carlos Aguado, Javier Sastre, Eduardo Díaz-Rubio, Center affiliate to the "Red Temática de Investigación Cooperativa (RD12/0036/006)", Instituto Carlos III, Spanish Ministry of Economy and Competitivity. Oncology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Javier
J
Sastre
Miguel Jhonatan Sotelo, Beatriz García-Paredes, Carlos Aguado, Javier Sastre, Eduardo Díaz-Rubio, Center affiliate to the "Red Temática de Investigación Cooperativa (RD12/0036/006)", Instituto Carlos III, Spanish Ministry of Economy and Competitivity. Oncology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Eduardo
E
Díaz-Rubio
D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D000068818:Cetuximab; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D066246:ErbB Receptors / Q000378:metabolism; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008024:Ligands; D008113:Liver Neoplasms / Q000556:secondary; D009154:Mutation; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D011518:Proto-Oncogene Proteins / Q000235:genetics / Q000378:metabolism; D016283:Proto-Oncogene Proteins p21(ras); D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D018631:ras Proteins / Q000235:genetics / Q000378:metabolism
D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D008024:Ligands; D009944:Organoplatinum Compounds; D011518:Proto-Oncogene Proteins; D042461:Vascular Endothelial Growth Factor A; D000077150:Oxaliplatin; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins; D000068818:Cetuximab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
Cetuximab; Colorectal liver metastases; Elderly patients; First-line; Metastatic colorectal cancer