Skip to main content

Cetuximab: Appraisal of a Novel Drug Against Colorectal Cancer

  • Chapter
Targeted Therapies in Cancer

Abstract

Cetuximab (C225, Erbitux, Merck, Darmstadt, Germany) is a human-mouse chimeric therapeutic monoclonal antibody (mAb) that competitively binds to the extracellular domain of the human epidermal growth-factor receptor (EGFR). It has been developed out of the murine antibody M225 “from bench to bedside” in less than two decades, and is the anti-EGFR mAb furthest ahead in clinical evaluation. In Europe, cetuximab is approved for the treatment of patients with EGFR-expressing, metastatic colorectal cancer after failure of treatment with irinotecan since 2004, and for the treatment of patients with locally advanced squamous cell cancer of the head and neck concomitant to radiotherapy since 2006. We here summarize the current role of cetuximab in the treatment of colorectal cancer, give an overview on the ongoing studies, address the most important controversies, and point out the chances and challenges for the future use of cetuximab in colorectal cancer and other human malignancies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Aboud-Pirak E, Hurwitz E, Pirak ME, Bellot F, Schlessinger J, Sela M (1988) Efficacy of antibodies to epidermal growth factor receptor against KB carcinoma in vitro and in nude mice. J Natl Cancer Inst 80:1605–1611

    Article  PubMed  CAS  Google Scholar 

  • Baselga J (2001) The EGFR as a target for anticancer therapy—focus on cetuximab. Eur J Cancer 37[Suppl 4]:S16–S22

    Article  PubMed  CAS  Google Scholar 

  • Baselga J (2002) Why the epidermal growth factor receptor? The rationale for cancer therapy. Oncologist 7[Suppl 4]:2–8

    Article  PubMed  CAS  Google Scholar 

  • Baselga J, Pfister D, Cooper MR, Cohen R, Burtness B, Bos M, D’Andrea G, Seidman A, Norton L, Gunnett K, Falcey J, Anderson V, Waksal H, Mendelsohn J (2000) Phase I studies of anti-epidermal growth factor receptor chimeric antibody C225 alone and in combination with cisplatin. J Clin Oncol 18:904–914

    PubMed  CAS  Google Scholar 

  • Bonner JA, Harari PM, Giralt J, Azarnia N, Shin DM, Cohen RB, Jones CU, Sur R, Raben D, Jassem J, Ove R, Kies MS, Baselga J, Youssoufian H, Amellal N, Rowinsky EK, Ang KK (2006) Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 354:567–578

    Article  PubMed  CAS  Google Scholar 

  • Burtness B (2005) The role of cetuximab in the treatment of squamous cell cancer of the head and neck. Expert Opin Biol Ther 5:1085–1093

    Article  PubMed  CAS  Google Scholar 

  • Chung KY, Saltz LB (2005) Antibody-based therapies for colorectal cancer. Oncologist 10:701–709

    Article  PubMed  CAS  Google Scholar 

  • Chung KY, Shia J, Kemeny NE, Shah M, Schwartz GK, Tse A, Hamilton A, Pan D, Schrag D, Schwartz L, Klimstra DS, Fridman D, Kelsen DP, Saltz LB (2005) Cetuximab shows activity in colorectal cancer patients with tumors that do not express the epidermal growth factor receptor by immunohistochemistry. J Clin Oncol 23:1803–1810

    Article  PubMed  CAS  Google Scholar 

  • Cunningham D, Humblet Y, Siena S, Khayat D, Bleiberg H, Santoro A, Bets D, Mueser M, Harstrick A, Verslype C, Chau I, Van Cutsem E (2004) Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med 351:337–345

    Article  PubMed  CAS  Google Scholar 

  • Díaz Rubio E, Tabernero J, van Cutsem E, Cervantes A, André T, Humblet Y, Soulié P, Corretgé S, Kisker O, de Gramont A (2005) Cetuximab in combination with oxaliplatin/5-fluorouracil (5-FU)/folinic acid (FA) (FOLFOX-4) in the first-line treatment of patients with epidermal growth factor receptor (EGFR)-expressing metastatic colorectal cancer: an international phase II study. Proc Am Soc Clin Oncol 24:A3535

    Google Scholar 

  • Folprecht G, Lutz MP, Schoffski P, Seufferlein T, Nolting A, Pollert P, Kohne CH (2006) Cetuximab and irinotecan/5-fluorouracil/folinic acid is a safe combination for the first-line treatment of patients with epidermal growth factor receptor expressing metastatic colorectal carcinoma. Ann Oncol 17:450–456

    Article  PubMed  CAS  Google Scholar 

  • Fornier M, Risio M, Van Poznak C, Seidman A (2002) HER2 testing and correlation with efficacy of trastuzumab therapy. Oncology (Williston Park) 16:1340–1348, 1351–1352; discussion 1352, 1355–1358

    PubMed  Google Scholar 

  • Harris M (2004) Monoclonal antibodies as therapeutic agents for cancer. Lancet Oncol 5:292–302

    Article  PubMed  CAS  Google Scholar 

  • Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, Berlin J, Baron A, Griffing S, Holmgren E, Ferrara N, Fyfe G, Rogers B, Ross R, Kabbinavar F (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342

    Article  PubMed  CAS  Google Scholar 

  • Laethem V, Raoul JL, Mitry E, Brezault C, Husseini F, Cals L, Vedovato JC, Mueser MM, Rougier P (2003) Cetuximab (C225) in combination with biweekly irinotecan (CPT-11), infusional 5-fluorouracil (5-FU) and folinic acid (FA) in patients (pts) with metastatic colorectal cancer (CRC) expressing the epidermal growth factor receptor (EGFR). Preliminary safety and efficacy results. Proc Am Soc Clin Oncol 22:A1058

    Google Scholar 

  • Lenz JR, Mayer RJ, Gold PJ, Mirtsching B, Stella PJ, Cohn AL, Pippas AW, Azarnia N, Needle MN, Van Cutsem E (2004) Activity of cetuximab in patients with colorectal cancer refractory to both irinotecan and oxaliplatin. Proc Am Soc Clin Oncol 23:A3510

    Google Scholar 

  • Machiels JP, Haustermans K, Coche JC, Sempoux C, Van Cutsem E, Canon JL, Coster B, Kerger J, Humblet Y, Scalliet P (2006) Phase I/II study of preoperative cetuximab, capecitabine, and external beam radiotherapy in patients with rectal cancer. ASCO GI Cancers Symp 3:A356

    Google Scholar 

  • Mendelsohn J, Baselga J (2003) Status of epidermal growth factor receptor antagonists in the biology and treatment of cancer. J Clin Oncol 21:2787–2799

    Article  PubMed  CAS  Google Scholar 

  • Overholser JP, Prewett MC, Hooper AT, Waksal HW, Hicklin DJ (2000) Epidermal growth factor receptor blockade by antibody IMC-C225 inhibits growth of a human pancreatic carcinoma xenograft in nude mice. Cancer 89:74–82

    Article  PubMed  CAS  Google Scholar 

  • Perez-Soler R (2003) Can rash associated with HER1/EGFR inhibition be used as a marker of treatment outcome? Oncology (Williston Park) 17:23–28

    PubMed  Google Scholar 

  • Perez-Soler R, Saltz L (2005) Cutaneous adverse effects with HER1/EGFR-targeted agents: is there a silver lining? J Clin Oncol 23:5235–5246

    Article  PubMed  Google Scholar 

  • Pfister DG, Su YB, Kraus DH, Wolden SL, Lis E, Aliff TB, Zahalsky AJ, Lake S, Needle MN, Shaha AR, Shah JP, Zelefsky MJ (2006) Concurrent cetuximab, cisplatin, and concomitant boost radiotherapy for locoregionally advanced, squamous cell head and neck cancer: a pilot phase II study of a new combined-modality paradigm. J Clin Oncol 24:1072–1078

    Article  PubMed  CAS  Google Scholar 

  • Posner MR, Wirth LJ (2006) Cetuximab and radiotherapy for head and neck cancer. N Engl J Med 354:634–636

    Article  PubMed  CAS  Google Scholar 

  • Prewett MC, Hooper AT, Bassi R, Ellis LM, Waksal HW, Hicklin DJ (2002) Enhanced antitumor activity of anti-epidermal growth factor receptor monoclonal antibody IMC-C225 in combination with irinotecan (CPT-11) against human colorectal tumor xenografts. Clin Cancer Res 8:994–1003

    PubMed  CAS  Google Scholar 

  • Rosenberg A, Loehrer P, Needle M, Waksal H, Hollywood H, Ramos L, Saltz L (2002) Erbitux (IMC-C225) plus weekly irinotecan (CPT-11), fluorouracil (5FU) and leucovorin (LV) in colorectal cancer (CRC) that expresses the epidermal growth factor receptor (EGFr). Proc Am Soc Clin Oncol 21:A536

    Google Scholar 

  • Saltz L (2005) Epidermal growth factor receptor-negative colorectal cancer: is there truly such an entity? Clin Colorectal Cancer 5[Suppl 2]:S98–S100

    Article  PubMed  CAS  Google Scholar 

  • Saltz L, Rubin M, Hochster H, Tchekmeydian N, Waksal H, Needle M, LoBuglio AF (2001) Cetuximab (IMC-C225) plus irinotecan (CPT-11) is active in CPT-11-refractory colorectal cancer that expresses epidermal growth factor receptor (EGFR). Proc Am Soc Clin Oncol 20:A7

    Google Scholar 

  • Saltz LB, Cox JV, Blanke C, Rosen LS, Fehrenbacher L, Moore MJ, Maraoun JA, Ackland SP, Locker PK, Pirotta N, Elfring GL, Miller MD (2000) Irinotecan plus 5-fluorouracil and leukovorin in for metastatic colorectal cancer. N Engl J Med 343:905–914

    Article  PubMed  CAS  Google Scholar 

  • Saltz LB, Meropol NJ, Loehrer PJ Sr, Needle MN, Kopit J, Mayer RJ (2004) Phase II trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J Clin Oncol 22:1201–1208

    Article  PubMed  CAS  Google Scholar 

  • Saltz LB, Lenz H, Hochster H, Wadler S, Hoff P, Kemeny N, Hollywood E, Gonen M, Wetherbee S, Chen H (2005) Randomized phase II trial of cetuximab/bevacizumab/irinotecan (CBI) versus cetuximab/bevacizumab (CB) in irinotecan-refractory colorectal cancer. Proc Am Soc Clin Oncol 24:A3508

    Google Scholar 

  • Seufferlein T, Dittrich C, Riemann J, Woell E, Herrmann T, Lordick F, Arnold D, Olchowka K, Hoehler T, Schmoll HJ (2005) A phase I/II study of cetuximab in combination with 5-fluorouracil (5-FU)/folinic acid (FA) plus weekly oxaliplatin (L-OHP) (FUFOX) in the first-line treatment of patients with metastatic colorectal cancer (mCRC) expressing epidermal growth factor receptor (EGFR). Preliminary results. Proc Am Soc Clin Oncol 23[Suppl]:3644

    Google Scholar 

  • Tournigand C, Andre T, Achille E, Lledo G, Flesh M, Mery-Mignard D, Quinaux E, Couteau C, Buyse M, Ganem G, Landi B, Colin P, Louvet C, de Gramont A (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 22:229–237

    Article  PubMed  CAS  Google Scholar 

  • Vallbohmer D, Zhang W, Gordon M, Yang DY, Yun J, Press OA, Rhodes KE, Sherrod AE, Iqbal S, Danenberg KD, Groshen S, Lenz HJ (2005) Molecular determinants of cetuximab efficacy. J Clin Oncol 23:3536–3544

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hildebrandt, B., le Coutre, P., Nicolaou, A., Kölble, K., Riess, H., Dörken, B. (2007). Cetuximab: Appraisal of a Novel Drug Against Colorectal Cancer. In: Dietel, M. (eds) Targeted Therapies in Cancer. Recent Results in Cancer Research, vol 176. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-46091-6_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-46091-6_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-46090-9

  • Online ISBN: 978-3-540-46091-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics