Introduction

Cetuximab is a chimeric human-murine monoclonal antibody against EGFR. Cetuximab has been approved since 2006 for the treatment of SCCHN, in combination with radiation therapy as the initial treatment of locally or regionally advanced tumors and as a single agent for patients with platinum-resistant cancers such as recurrent or metastatic SCCHN. This drug has also been approved since 2004 for the treatment of EGFR-expressing metastatic colorectal cancer as a single agent or in combination with irinotecan for patients with chemotherapy-refractory cancers[1].

Uses and indications

KRAS Wild-type, EGFR Expressing Metastatic Colorectal Cancer:

Cetuximab is indicated for KRAS mutation-negative (wild-type), epidermal growth factor receptor (EGFR)-expressing colorectal cancer (CRC) as determined by FDA-approved tests. Indications include:
Indicated in combination with FOLFIRI (irinotecan, fluorouracil, leucovorin) for first-line treatment;
Indicated in combination with irinotecan in patients refractory to irinotecan-based chemotherapy;
It is indicated as a single agent in failed oxaliplatin- and irinotecan-based chemotherapy or in patients intolerant to irinotecan.

BRAF V600E Mutation-Positive Metastatic Colorectal Cancer:

This drug is indicated in combination with encorafenib for metastatic colorectal cancer (CRC) with a BRAF V600E mutation (as determined by an FDA-approved test) after prior therapy

Advanced Squamous Cell Carcinoma of Head & Neck:

Indications include:
Indicated in combination with radiation therapy for initial treatment of local or regional cancer;
Indicated in combination with platinum-based therapy with 5-FU for first-line treatment of patients with recurrent locoregional disease or metastatic form;
Indicated as monotherapy in patients with recurrent or metastatic carcinoma for whom prior platinum-based therapy failed.

Side effect

Cutaneous side effects are the most common adverse reactions occurring during epidermal growth factor receptor inhibitors (EGFRI) therapy. Papulopustular rash (acne-like rash) develops in 80- 86% of patients receiving cetuximab, while xerosis, eczema, fissures, teleangiectasiae, hyperpigmentations, and nail and hair changes occur less frequently. The mechanism underlying these skin changes has yet to be established and understood. The epidermal growth factor receptor inhibition alters cell growth and differentiation, leading to impaired stratum corneum and cell apoptosis[2].

References

[1] W Bou-Assaly, S Mukherji. “Cetuximab (erbitux).” American Journal of Neuroradiology 31 4 (2010): 626–7.

[2] Da?ka ?tulhofer Buzina. “Adverse Reaction to Cetuximab, an Epidermal Growth Factor Receptor Inhibitor.” Acta Dermatovenerologica Croatica 24 1 (2016): 70–2.