EGFR antagonist, Cetuximab is used in cases of
|A||Palliative t/t of head and neck cancer|
|B||Anal canal carcinoma|
|D||Small cell lung carcinoma|
a. Cetuximab and pemtumomab (Vectibix) are directed against the epidermal growth factor receptor (EGFR), a transmembrane glycoprotein involved in signaling pathways affecting growth and proliferation of tumor cells.
b. Both cetuximab and pemtumomab, when given alone, have been shown to benefit a small proportion of previously treated patients
c. Cetuximab appears to have therapeutic synergy with such chemotherapeutic agents as irinotecan, even in patients previously resistant to this drug; this suggests that cetuximab can reverse cellular resistance to cytotoxic chemotherapy.
d. The use of both cetuximab and pemtumomab can lead to an acne-like rash with the development and severity of the rash being correlated with the likelihood of antitumor efficacy.
e. Inhibitors of the EGFR tyrosine kinase such as erlotinib (TarcevA. do not appear to be effective in colorectal cancer
Harrison has given a extensive table for molecularly targeted therapy. In this use of cetuximab in head & neck cancers is mentioned.
Note: PML-RAR, promyelocytic leukemia–retinoic acid receptor-alpha; AML, acute myeloid leukemia; t(15;17), translocation between chromosomes 15 and 17; VEGFR, vascular endothelial growth factor receptor; PDGFR, platelet-derived growth factor receptor; Flt-3, fms-like tyrosine kinase-3; GIST, gastrointestinal stromal tumor; RCC, renal cell cancer; EGFR, epidermal growth factor receptor; TGF-, transforming growth factor alphA.
According to GG – cetuximab can be used in all those cancers, which express EGFR – head & neck, breast, lung, kidney, prostate, brain and Pancreas.