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The Pharmaceutical Journal
Vol 270 No 7253 p819
14 June 2003

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Cetuximab benefits colorectal cancer patients resistant to standard therapy

David Cunningham: cetuximab seems to resensitise cancer cells

Cetuximab seems to modulate resistance to standard chemotherapy drugs and is a promising treatment for metastatic colorectal cancer, Dr David Cunningham, Royal Marsden Hospital, Sutton, said at the annual American Society of Clinical Oncology meeting.

He presented results of a trial involving 329 patients whose disease was worsening despite treatment with irinotecan (Campto). The trial was designed to test the effect of a combination of cetuximab plus irinotecan, and of cetuximab alone in patients with irinotecan-refactory disease. The two-drug combination shrank tumours in 22.9 per cent of patients whereas the single agent shrank tumours in 10.8 per cent.

"Cetuximab is clearly a valuable agent on its own but it also seems to be able to modulate resistance to conventional cytotoxic drugs. It resensitises cells to conventional chemotherapy," Dr Cunningham said.

The study also revealed that patients who received cetuximab and irinotecan had tumour progression delayed for longer than those who received cetuximab alone (4.1 months versus 1.5 months). The one year survival rates were approximately 30 per cent for both treatment groups.

Dr Cunningham added that cetuximab, a monoclonal antibody that targets epidermal growth factor receptor, is also being tested in combination with platinum-based drugs.

Dr Robert Mayer, Dana-Farber Cancer Institute, Boston, Massachusetts, commented that there had been some controversy surrounding cetuximab and that this had retarded its development. "This report from the United Kingdom clearly indicates that cetuximab is active in colon cancer and justifies its use in studies in Europe and the United States," he said.

Anti-angiogenesis agent The anti-angiogenesis agent bevacizumab extends survival for patients with metastatic colorectal cancer when given with standard chemotherapy, conference participants were told. Patients who received bevacizumab in combination with irinotecan and 5-flurouracil/folinic acid survived for a median of 20.3 months compared with 15.6 months for patients given irinotecan and 5-FU/FA alone (P=0.00003). Bevacizumab is an antibody designed to inhibit vascular endothelial growth factor, a protein involved in tumour angiogenesis.

The Journal attended the 39th annual meeting of the American Society of Clinical Oncology, held in Chicago, Illinois, from 31 May until 3 June, courtesy of Eli Lilly. It was attended by more than 25,000 cancer specialists