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cetuximab (Erbitux)
Tradename: Erbitux FDA approved 2004
Indications:
1) adjuvant chemotherapy for colorectal carcinoma
a) used in combination with irinotecan
b) has not been shown to improve survival [2]
2) cetuximab as single agent for colorectal carcinoma increases survival [3], 6.1 vs 4.6 months for supportive care
3) head & neck cancer
4) lung cancer
Adverse effects:
- rash
- fatigue
- hypomagnesemia
- hypersensitivity
Laboratory:
- test for EGFR expression
- KRAS mutations
Mechanism of action:
- monoclonal antibody to epidermal growth factor receptor (EGFR)
- inactive in colorectal cancer patients with KRAS mutations [4,6]
* ImClone drug implicated in Martha Stewart case (2004)
Interactions
drug adverse effects of tyrosine kinase inhibitor(s)
General
antineoplastic monoclonal antibody
EGF receptor (EGFR) inhibitor
References
- Geriatrics Review Syllabus, American Geriatrics Society,
5th edition, 2002-2004
- FDA Approves Erbitux for Colorectal Cancer
Prescriber's Letter 11(3):16,17 2004
Detail-Document#: 200311
(subscription needed) http://www.prescribersletter.com
- Jonker DJ et al,
Cetuximab for the treatment of colorectal cancer.
N Engl J Med 2007, 357:2040
PMID: 18003960
- Lievre A et al,
KRAS mutations as an independent prognostic factor in patients
with advanced colorectal cancer treated with cetuximab.
J Clin Oncol 2008, 26:374
PMID: 18202412
- Medical Knowledge Self Assessment Program (MKSAP) 15, 16.
American College of Physicians, Philadelphia 2009, 2012
- Patil DT, Fraser CR, Plesec TP.
KRAS testing and its importance in colorectal cancer.
Curr Oncol Rep. 2010 May;12(3):160-7.
PMID: 20425075
- Tol J, Punt CJ.
Monoclonal antibodies in the treatment of metastatic
colorectal cancer: a review.
Clin Ther. 2010 Mar;32(3):437-53.
PMID: 20399983