Cetuximab and other anti-epidermal growth factor receptor monoclonal antibodies in the treatment of non-small cell lung cancer.

Non-small cell lung cancer (NSCLC) accounts for about 85% of all new diagnoses of lung cancer. Unfortunately, few NSCLC patients are suitable for radical treatment for curative intent. Because most patients with NSCLC have advanced disease at diagnosis, chemotherapy represents the standard of care, although, to date, a plateau has been reached with this approach. Improvements in the knowledge of tumor biology and mechanisms of oncogenesis have identified the epidermal growth factor receptor (EGFR), a member of the ErbB family, as a molecular target for NSCLC treatment. EGFR is commonly overexpressed in NSCLC and has been associated with impaired prognosis; therefore, its inhibition may lead, through the suppression of tumor proliferation, to improvement in clinical outcomes. Strategies to block EGFR include tyrosine kinase inhibitors, monoclonal antibodies, ligand-linked toxins, and antisense approaches. This article focuses on the treatment of NSCLC with the anti-EGFR monoclonal antibodies, including cetuximab, for which the largest amount of data in the literature exists. Recently, a phase III randomized trial performed in advanced NSCLC patients yielded a statistically significant survival advantage for patients treated with cetuximab plus chemotherapy versus chemotherapy alone. Other anti-EGFR monoclonal antibodies, such as panitumumab, matuzumab, nimotuzumab, and ch806, are in different stages of development for the treatment of advanced NSCLC.