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Gastrointestinal Cancer

Administration of Cetuximab Every 2 Weeks in the Treatment of Metastatic Colorectal Cancer: An Effective, More Convenient Alternative to Weekly Administration?

^aVall d'Hebron University Hospital, Barcelona, Spain; ^bOdense University Hospital, Odense C, Denmark; ^cHospital Clínico, Universidad de Valencia, Valencia, Spain

Key Words. Cetuximab • Colorectal cancer • Every two weeks • Pharmacodynamics • Pharmacokinetics • Weekly

Correspondence: Josep Tabernero, M.D., Medical Oncology Department, Vall d'Hebron University Hospital, P. Vall d'Hebron, 119–129, 08035, Barcelona, Spain. Telephone: 34-93-274-6085; Fax: 34-93-274-6059; e-mail: jtabernero{at}vhebron.net

Disclosure: J.T. has acted as a consultant to Merck KGaA. No other potential conflicts of interest were reported by the authors, planners, reviewers, or staff managers of this article.

The primary purpose of this paper is to present the available evidence for the administration of cetuximab on an every-2-weeks basis in combination with irinotecan in metastatic colorectal cancer (mCRC). Cetuximab is an epidermal growth factor receptor–targeted IgG₁ monoclonal antibody that is approved for use in combination with irinotecan or as monotherapy in the treatment of mCRC. The currently approved dosing regimen for cetuximab is a 400-mg/m² initial dose followed by 250 mg/m² weekly. Many commonly used chemotherapy agents for mCRC (including irinotecan alone or in combination with 5-fluorouracil [5-FU]/folinic acid [FA] and oxaliplatin plus 5-FU/FA) are administered on an every-2-weeks basis. The ability to synchronize the administration of cetuximab and concomitant chemotherapy is desirable for both patients and health care workers. A cetuximab dose of 500 mg/m² every 2 weeks exhibited predictable pharmacokinetics, which were similar to those of the approved weekly dosing regimen. Active serum concentrations of cetuximab were maintained throughout the 2-week dosing period with this regimen. There was no difference between the dosing regimens on pharmacodynamic parameters in skin. The efficacy and safety of the every-2-weeks dosing regimen were similar to those reported for the approved weekly dosing regimen. The indication from these preliminary findings is that every-2-weeks administration of cetuximab (500 mg/m²) may be a potentially convenient alternative to the approved weekly dosing regimen of 250 mg/m² (following an initial dose of 400 mg/m²) in the treatment of mCRC.