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Anti–Epidermal Growth Factor Receptor Monotherapy in the Treatment of Metastatic Colorectal Cancer: Where Are We Today?

^aDepartment of Hepatogastroenterology, Digestive Oncology Unit, University Hospital Ghent, Gent, Belgium; ^bDepartment of Haematology and Oncology, Queen Elizabeth Hospital, Woodville, Australia; ^cDepartment of Gastroenterology, Gastrointestinal Cancer Unit, Erasme University Hospital, Brussels, Belgium

Key Words. Panitumumab • Cetuximab • EGFR • mCRC • Monotherapy

Correspondence: Correspondence: Marc Peeters, M.D., Ph.D., Department of Hepatogastroenterology, Digestive Oncology Unit, University Hospital Ghent, De Pintelaan 185, B-9000 Gent, Belgium. Telephone: 32-9-332-23-81; Fax: 32-9-332-49-84; e-mail: marc.peeters{at}ugent.be

Received August 1, 2008; accepted for publication December 1, 2008.

Disclosure: Employment/leadership position: None; Intellectual property rights/inventor/patent holder: None; Consultant/advisory role: Timothy Price, Amgen; Honoraria: Marc Peeters, Amgen, Merck Serono; Research funding/contracted research: Marc Peeters, Amgen, Merck Serono; Ownership interest: None; Expert testimony: None; Other: None. The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or staff managers.

Over the past 10 years there has been a significant increase in the armamentarium of agents available for use in the treatment of advanced colorectal cancer (CRC). Among these new agents are two monoclonal antibodies targeting the epidermal growth factor receptor (EGFR): cetuximab, a mouse–human chimeric monoclonal antibody, and panitumumab, a fully human monoclonal antibody. Both are approved as monotherapy for the treatment of chemotherapy-refractory advanced CRC. Cetuximab is also indicated for use in combination with irinotecan. Here, we review 10 reports of phase II and III clinical studies of patients treated with panitumumab or cetuximab monotherapy. The clinical trials demonstrate similar efficacy profiles for advanced CRC patients treated with panitumumab and cetuximab monotherapy, with some differences in their adverse event profiles. In addition, the recent results of retrospective tumor KRAS gene mutational analyses in CRC patients treated with anti-EGFR monotherapy are reviewed. Data from the clinical trials reviewed here clearly demonstrate that anti-EGFR monotherapy is an effective treatment modality for patients with chemotherapy-refractory advanced CRC.

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