Published online Jun 21, 2016. doi: 10.3748/wjg.v22.i23.5332
Peer-review started: March 22, 2016
First decision: April 14, 2016
Revised: May 2, 2016
Accepted: May 21, 2016
Article in press: May 23, 2016
Published online: June 21, 2016
Although monoclonal antibodies (mAbs) against epidermal growth factor receptor (EGFR) have largely enriched the available therapeutic choices for colorectal cancer (CRC), the understanding and management of their associated clinical toxicities are limited. In addition, the combined strategies of administering EGFR mAbs and traditional cytotoxic agents, such as 5-fluorouracil, oxaliplatin and irinotecan, have resulted in a more complicated management of CRC treatment-related side effects compared with EGFR mAb monotherapy. We believe that a thorough recognition of the toxicities of EGFR mAb drugs is essential for physicians to increase the therapeutic index in the treatment of CRC. This review aims to summarize the existing information regarding the treatment dilemmas of cetuximab combined with chemotherapy in the management of metastatic CRC.
Core tip: The advent of epidermal growth factor receptor monoclonal antibodies (EGFR mAbs), especially cetuximab, has provided a meaningful transformation in the available treatment options for advanced colorectal cancer (CRC). Nevertheless, their efficacy is accompanied by some undesired complications. Additionally, combination treatments comprising EGFR mAbs and traditional cytotoxic agents have resulted in a more complex management of CRC treatment-related side effects. Therefore, it is imperative to understand and appropriately address the treatment dilemmas of cetuximab combined with chemotherapy for the management of metastatic CRC.