By Dr Ananya Mandal, MD
Cetuximab is a monoclonal antibody that inhibits the epidermal growth factor receptor (EGFR) which is present on the surface of some cancer cells. Cetuximab binds to the receptor, preventing epidermal growth factor (EGF) from binding to it and stimulating growth of the cancer cells.
Cetuximab is approved for use in:
Head and Neck Cancer – Cetuximab is used to treat squamous cell cancer of the head and neck. Cetuximab is commonly used alongside chemotherapy as a first line approach to cancer that has spread or is recurring. It is also used alongside radiation therapy in localized disease.
Advanced bowel cancer or cancer of the colon and rectum – Patients with metastatic colorectal cancer that expresses EGFR may be treated with cetuximab in combination with chemotherapy or cetuximab may be given as a single therapy to patients who have failed to respond to irinotecan- and oxaliplatin-based regimens.
Use and dosage
The drug is usually administered at an initial dose of 400 mg per squared meter of surface body area over 120 minutes, followed by a dose of 250 mg per squared meter of body surface area once a week over a 1-hour infusion.
Side effects and warnings
Patients may develop an acne-like skin reaction, but this does not usually lead to dose reductions or cessation of treatment.
Itching, mouth sores, infections, low electrolyte levels and fatigue are other common side effects.
Les common reactions to infusion include fever, chills, headache nausea, vomiting, diarrhea, weight loss and altered electrolyte levels.
More rare and serious side effects include severe reactions such as breathing difficulties, tightness in the throat, heart attack, and cardiac arrest. Patients are therefore carefully monitored when cetuximab is being administered. Some patients may also develop lung toxicity as a result of cetuximab infusion.
Cetuximab should only be used to treat pregnant woman if the treatment benefits outweigh the risks as the therapy can cause severe damage to the fetus. Cetuximab can also be passed onto the baby through breast milk and treatment with the drug is discontinued while a mother is nursing. Breastfeeding should not be resumed until at least 60 days after treatment with cetuximab was stopped.
Reviewed by Sally Robertson, BSc