What is the role of necitumumab in the treatment of non–small cell lung cancer (NSCLC)?

Updated: Jun 05, 2020
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

Necitumumab is another monoclonal antibody that binds to human EFGR and blocks the interaction between EGFR and its ligands. It was approved in November 2015 for first-line treatment of metastatic squamous NSCLC in combination with gemcitabine and cisplatin. Approval was based on the SQUIRE trial, conducted in 1093 patients, which showed a 1.6-month improvement in overall survival (OS) when necitumumab was added to a regimen of gemcitabine and cisplatin. The median OS was 11.5 months, compared with 9.9 months for gemcitabine and cisplatin alone. [170]

However, current NCCN guidelines recommend against use of the necitumumab/cisplatin/gemcitabine regimen for patients with metastatic squamous cell NSCLC, based on the opinion that the addition of necitumumab to the regimen is not beneficial based on toxicity, cost, and limited improvement in efficacy when compared with cisplatin/gemcitabine. Specifically, the NCCN panel notes that the addition of necitumumab resulted in only a slight improvement in overall survival and an increase in grade 3 or higher adverse events. [91]


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