Epidermal growth factor receptor monoclonal antibodies for the treatment of metastatic colorectal cancer.

摘要: Treatment of metastatic colorectal disease has evolved over the last decade. Two epidermal growth factor receptor (EGFR) monoclonal antibodies--cetuximab and panitumumab--have been developed in an effort to provide yet another therapeutic option. The EGFR is a transmembrane glycoprotein, expressed constitutively throughout body found on many epithelial tissues. antibodies bind inhibit activation body. This inhibition prevents tumor cell growth, angiogenesis, invasion, metastasis, induces apoptosis. Cetuximab panitumumab exhibit nonlinear pharmacokinetics. Both are approved for treatment refractory cancer. combination with irinotecan significantly better response rates progression-free survival compared those cetuximab or alone. as monotherapy have shown best supportive care patients oxaliplatin. In Combined Irinotecan First Line Therapy Metastatic Colorectal Cancer (CRYSTAL) trial, treatment-naive received chemotherapy regimen infusional leucovorin, fluorouracil, (FOLFIRI) FOLFIRI alone; difference was statistically significant but suggested only modest benefit alone (8.9 vs 8 mo, p=0.036). Results preplanned analysis first 231 events Panitumumab Advanced Evaluation (PACCE) trial favored control group (chemotherapy folinic acid [leucovorin], oxaliplatin [FOLFOX] plus bevacizumab) instead panitumumab. For clinical consideration, trials that intensity absence expression not clinically predictor outcomes. Development rash be positive outcomes patients. most common adverse antibody therapy rash, diarrhea, hypomagnesemia. Other serious include hypersensitivity reactions pulmonary toxicity. availability provided weapon arsenal treat They safety efficacy other regimens monotherapy; however, their use cancer needs further explored.