Clinical Medicine Reviews in Oncology

Metastatic colorectal cancer (mCRC) is primarily treated with cytotoxic chemotherapy. However, limitations in efficacy and tolerability clearly exist with the use of these agents. Molecularly targeted agents offer alternatives to chemotherapy or in many cases, can be used in combination with chemotherapy to synergistically enhance responses and patient survival. Monoclonal antibodies targeting the epidermal growth factor receptor (EGFR) have emerged as a therapeutic option to potentiate chemotherapeutic response and outcome in mCRC patients. However, in unselected populations, the advantages are modest. Thus, biomarkers that predict patients who will benefit from combination regimens employing both EGFR-targeted agents and chemotherapy are necessary to limit unnecessary toxicity and healthcare costs. This review will discuss the use of the EGFR monoclonal antibody cetuximab in combination with chemotherapy in mCRC patients with respect to toxicity, response, and predictive biomarkers of activity.