UNC logoPatients with metastatic colorectal cancer or head and neck cancer may be recommended to include the drug cetuximab in their treatment. A latest research seemingly reveals new recommendations on the use of the drug cetuximab. The recommendations were made after official’s stopped enrollment in a phase III clinical trial in patients with spread of colon cancer into regional lymph nodes whose tumors had been surgically eradicated.

Cetuximab is considered in the treatment list for patients with advanced colorectal cancer whose tumors do not have a mutation in the KRAS gene. The scientists explained that tumors cells can grow, divide and evade signals that shut the cells down causing their death by KRAS which is a series of genes along a pathway.

Inclusion of cetuximab a standard chemotherapy regimen in earlier stages of colon cancer was anticipated to reveal identical benefits. But no extreme benefits were apparently noted in patients provided with a combination of therapy in the ongoing research during the clinical trial.

Richard Goldberg, MD, chief of the division of hematology/oncology at the UNC-Chapel Hill School of Medicine, who presented the results for this group of patients and who is also physician-in-chief of the N.C. Cancer Hospital said, “We expected that patients with the genetic mutation would not respond to cetuximab, and that is what we found. However, even the patients in the research whose tumors did not harbor the KRAS mutation did not benefit significantly from the combination therapy and the standard treatment proved to have the best results. We also found that the combination therapy was more toxic and the side effects of treatment – especially in older patients – negatively impacted their ability to complete the standard treatment.”

Cetuximab is known as a monoclonal antibody that inhibits epidermal growth factor receptor (EGFR) which is a cell signaling pathway contributing to tumor growth. It was unraveled that approximately 40 percent patients with metastatic colon cancer having a mutated KRAS gene are unable to respond positively to the present day EGFR inhibitors. The genetic test for KRAS mutation does not seem to be standard until now.

While conducting the research, patients recruited before KRAS testing were secluded and examined separately from other research participants. The recommendation disapproves the employment of cetuximab in patients with stage III colon cancer. The researchers mentioned that the drug is crucial for treating patients with advanced colorectal cancers whose tumors do not harbor a KRAS mutation and can either be administered as a single agent or with chemotherapy.

The research is published in the July 2010 issue of the American Society for Clinical Oncology Post.