Cetuximab combined with chemotherapy in non-small cell lung cancer

The IgG1 chimerized monoclonal antibody cetuximab (Erbitux) blocks ligand binding to the epidermal growth factor receptor. Its effects potentiate apoptosis and inhibit cell cycle progression, invasion, and metastasis while also decreasing tumor cell production of angiogenic factors. It is also suspected to enhance immune response via antibody-dependent cellular cytotoxicity. Based on data from the phase III FLEX trial and the BMS-099 study, cetuximab is currently under review by the US Food and Drug Administration (FDA) for use in non-small cell lung cancer (it is currently approved for use in colorectal cancer and head and neck squamous cell carcinoma). This article will summarize the trial results of cetuximab combined with platinum-based chemotherapy in chemotherapy-naive patients with metastatic non-small cell lung cancer. Recent developments in biomarker research and their applicability to clinical decision-making will be discussed.