Which medications in the drug class Antineoplastic Agent, Monoclonal Antibody are used in the treatment of Colon Cancer?

Updated: Apr 15, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Antineoplastic Agent, Monoclonal Antibody

These agents target factors responsible for deregulated cell proliferation.

Cetuximab (Erbitux)

Recombinant, human/mouse chimeric monoclonal antibody that specifically binds to the extracellular domain of human epidermal growth factor receptors (EGFR, HER1, c-ErbB-1). Cetuximab-bound EGF receptor inhibits activation of receptor-associated kinases, resulting in inhibition of cell growth, induction of apoptosis, and decreased production of matrix metalloproteinase and vascular endothelial growth factor.

Indicated for treatment of KRAS mutation-negative (wild-type) EGFR-expressing, metastatic colorectal cancer for the following: 1) in combination with FOLFIRI 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.

Bevacizumab (Avastin, Mvasi)

Murine derived monoclonal antibody that inhibits angiogenesis by targeting and inhibiting vascular endothelial growth factor (VEGF). Inhibiting new blood vessel formation denies blood, oxygen, and other nutrients needed for tumor growth. Bevacizumab is indicated in combination with a fluoropyrimidine-based chemotherapy as a first-line or second-line treatment for metastatic colorectal cancer. It is also indicated for second-line treatment in patients who have progressed on a first-line bevacizumab-containing regimen. For continuation therapy, use bevacizumab in combination with a fluoropyrimidine (eg, 5-FU, capecitabine) plus irinotecan or oxaliplatin-based chemotherapy. Mvasi has been FDA-approved as a biosimilar to Avastin but not as an interchangeable product.

Panitumumab (Vectibix)

Recombinant human IgG2 kappa monoclonal antibody that binds to human epidermal growth factor receptor (EGFR). Indicated for wild-type KRAS (exon 2 in codons 12 or 13) metastatic colororectal carcinoma, as determined by an FDA-approved test. Indicated as second-line, monotherapy following disease progression after prior treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy. Also indicated as first-line therapy in combination with FOLFOX.

Ipilimumab (Yervoy)

Recombinant human cytotoxic T-lymphocyte antigen 4 (CTLA-4) - blocking antibody. It is indicated in combination with nivolumab for adults with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer (CRC) which progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan.

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