Evaluating the Role of Cetuximab in Metastatic Colorectal Cancer

Benjamin Weinberg, MD, assistant professor of medicine, Division of Hematology and Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, discusses his treatment decisions for patients with metastatic colorectal cancer (mCRC) and the role of cetuximab (Erbitux) in this patient population.

In the past, physicians thought cetuximab only worked in patients with mCRC who wereRASand BRAFwild-type, Weinberg says. It was known that patients with right-sided CRC—whose tumors rose from the cecum, ascending colon, hepatic flexure, or beginning of the transverse colon—had worse prognoses than those patients with left-side mCRC arising from the primary splenic flexure, descending colon, sigmoid, rectosigmoid, and rectum.

Weinberg says now we know that EGFR-targeted therapies only seem to work upfront for patients with left-sided primary tumors andRASwild-type tumors. He notes that he would be remiss if he used an anti-EGFR agent in a patient with right-sided CRC until a much later line of therapy, and only in those who are RASor BRAFwild-type. The only exception to this, however, remains the patients with BRAF