Last Modified: November 12, 2006
Dear OncoLink "Ask The Experts,"
My father was diagnosed with stage III colon cancer earlier this month. He had surgery to remove the cancerous portion of the colon. He then consulted two doctors; one suggested using cetuximab in combination with the chemotherapy, and the other doctor ruled against it.
The doctor who suggests using cetuximab felt [that] a more aggressive treatment might be good in his case. However, the doctor who is against it feels that there are no signs of cancer in other organs, and there is no scientific proof or statistics that using cetuximab at his stage helps, since there is no metastasis found. Have there been any reports or any findings to indicate that cetuximab would be beneficial to use in a stage III patient?
Bruce Giantonio, MD, Assistant Professor of Medicine in the Hematology-Oncology Division at the University of Pennsylvania, responds:
There is no information at this time that tells us that using cetuximab in this way would improve on the benefits of standard chemotherapy. And while we often get excited about the use of new drugs when they have shown activity in the metastatic disease setting, we have learned in the past that we need to be careful about our willingness to use them in the 'adjuvant' setting, as is described here, because they might not work as we hoped them to. Furthermore, using them in this unproven setting might just add side effects, some of which could be life-threatening.
There is a clinical study available at The University of Pennsylvania, and other institutions nationally, that would be an ideal solution for this individual. This study is sponsored by the National Cancer Institute of the National Institutes of Health, and seeks to determine the answer to this question. The study is entitled "Comparison of Combination Chemotherapy Regimens With or Without Cetuximab in Treating Patients Who Have Undergone Surgery for Stage III Colon Cancer" (N0147), and all patients get standard chemotherapy (FOLFOX), half with cetuximab and half without cetuximab. Use our clinical trials matching service to find this trial at a location near you. It is through clinical trials like this one that we find the answers to these treatment questions.