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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2016; 22(23): 5332-5341
Published online Jun 21, 2016. doi: 10.3748/wjg.v22.i23.5332
Treatment dilemmas of cetuximab combined with chemotherapy for metastatic colorectal cancer
Feng Wen, Qiu Li
Feng Wen, Qiu Li, Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wen F and Li Q conceived the topic, contributed to the writing and revising, and both provided overall design and execution of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Qiu Li, Professor, Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. fbqiu9@163.com
Telephone: + 86-28-85423609 Fax: + 86-28-85423262
Received: March 21, 2016
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
Abstract

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.

Keywords: Cetuximab, Colorectal cancer, Metastatic, Toxicity, Chemotherapy

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.