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What is Cetuximab (an EGFR antagonist) can be used in: and explain in detail?
CETUXIMAB: It is a chimeric monoclonal antibody directed to the extracellular domain of the EGF receptor. USES: Colorectal Cancer Indications Indicated for treatment of KRAS mutation-negative (wild-type), epidermal growth factor receptor (EGFR)-expressing, metastatic colorectal cancer as determine by FDA-approved tests (eg, therascreen KRAS RGQ PCR Kit) for this use Determine EGFR-expression status using FDA-approved tests prior to initiating treatment; also confirm absence of a Ras mutation prior to initiation of treatment 1) In combination with FOLFIRI (irinotecan, 5-fluorouracil, leucovorin) for first-line treatment, 2) In combination with irinotecan in patients who are refractory to irinotecan-based chemotherapy, and 3) As a single agent in patients who have failed oxaliplatin- and irinotecan-based chemotherapy or who are intolerant to irinotecan Dosage Dosage is for either monotherapy or in combination Loading Initial dose: 400 mg/m2 IV infused over 2 hr Maintenance: 250 mg/m2 IV infusion over 60 min qWeek until disease progression or unacceptable toxicity Complete cetuximab administration 1 hr prior to FOLFIRI Not to exceed infusion rate of 10 mg/min Limiation of use Not indicated for the treatment of patients with colorectal cancer that harbor somatic mutations in exon 2 (codons 12 and 13), exon 3 (codons 59 and 61), and exon 4 (codons 117 and 146) of either K-Ras or N-Ras (referred to as Ras) or when he results of the Ras mutation tests are unknown Head & Neck Cancer Indications Indicated for initial treatment of locally or regionally advanced squamous cell carcinoma of head/neck with radiation therapy Monotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck progressing after platinum-based therapy Combined with platinum-based therapy with 5-FU for metastatic head and neck cancer Initial dose: 400 mg/sm2 IV infused over 2 hr Subsequent doses: 250 mg/m2/week; infuse over 60 minutes (not to exceed 10 mg/min) With radiation: Initiate 1 week prior to beginning radiation therapy, continue qWeek x 6-7 weeks With platinum-based therapy with 5-FU: Initiate on the day beginning chemotherapy; complete cetuximab infusion 1 hr prior to administering platinum-based therapy with 5-FU Monotherapy or with chemotherapy: Administer qWeek until disease progression or unacceptable toxicity REFERENCE: www.medscape.com