Treatment of wild-type RAS metastatic colorectal cancer
in patients with tumours expressing epidermal growth
factor receptor, as combination therapy, or as
monotherapy if oxaliplatin- and irinotecan-based
therapy has failed or if irinotecan is not tolerated |
Treatment of locally advanced squamous cell cancer of
the head and neck (in combination with radiotherapy) |
Treatment of recurrent or metastatic squamous cell
cancer of the head and neck (in combination with
Immune system and malignant disease
platinum-based chemotherapy)
▶BY INTRAVENOUS INFUSION
▶Adult (initiated by a specialist): (consult product
literature or local protocols)
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RAS mutated colorectal tumours (or
if RAS tumour status unknown)
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Cardiopulmonary disease. cardiovascular
disease. history of keratitis. pulmonary disease—
discontinue if interstitial lung disease. risk factors for
keratitis. severe dry eye. ulcerative keratitis (including
contact lens use)
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Evidence of non-mutated
(wild-type) RAS status (at exons 2, 3 and 4 of KRAS and
NRAS) is required before cetuximab is initiated for the
treatment of metastatic colorectal cancer, and should be
determined by an experienced laboratory using a validated
test method.
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NICE decisions
▶Cetuximab for the treatment of locally advanced squamous
cell cancer of the head and neck (June 2008) NICE TA145
Cetuximab in combination with radiotherapy is an option
for the treatment of locally advanced squamous cell cancer
of the head and neck in patients who have a Karnofsky
performance status of 90% or greater and when all forms
of platinum-based chemoradiotherapy treatment are
contra-indicated.
www.nice.org.uk/guidance/ta145
▶Cetuximab, bevacizumab and panitumumab for the treatment
of metastatic colorectal cancer after first-line chemotherapy
(January 2012) NICE TA242
Cetuximab monotherapy or combination chemotherapy is
not recommended for the treatment of patients with
metastatic colorectal cancer that has progressed after first-
line chemotherapy.
www.nice.org.uk/guidance/ta242
▶Cetuximab and panitumumab for previously untreated
metastatic colorectal cancer (updated September 2017)
NICE TA439
Cetuximab is recommended, within its marketing
authorisation, as an option for previously untreated
epidermal growth factor receptor-expressing, RAS wild-
type metastatic colorectal cancer in patients in
combination with:
. 5-fluorouracil, folinic acid and oxaliplatin (FOLFOX), or
. 5-fluorouracil, folinic acid and irinotecan (FOLFIRI).
This advice is contingent upon the manufacturer providing
cetuximab with the discount agreed in the commercial
access agreement.
www.nice.org.uk/guidance/ta439
▶Cetuximab for treating recurrent or metastatic squamous cell
cancer of the head and neck (August 2017) NICE TA473
Cetuximab in combination with platinum-based
chemotherapy is recommended as an option for treating
recurrent or metastatic squamous cell cancer of the head
and neck in patients only:
. if the cancer started in the oral cavity, and
. when the company provides the drug in line with the
commercial access agreement with NHS England.
Patients currently receiving cetuximab whose disease does
not meet the above criteria may continue treatment until
they and their clinician consider it appropriate to stop.
www.nice.org.uk/guidance/ta473
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