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di Noia V, D'Argento E, Pilotto S, Grizzi G, Caccese M, Iacovelli R, Tortora G, Bria E. Necitumumab in the treatment of non-small-cell lung cancer: clinical controversies. Expert Opin Biol Ther 2018; 18:937-945. [PMID: 30075697 DOI: 10.1080/14712598.2018.1508445] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Over the last decade, epidermal growth factor receptor (EGFR) signaling was investigated as a potential target for tyrosine kinase inhibitors in the treatment of non-small-cell lung cancer (NSCLC). Necitumumab is a fully humanized IgG1 monoclonal antibody directed against the binding domain of EGFR, approved in combination with cisplatin-gemcitabine for the first-line treatment of squamous NSCLC. Areas covered: The purpose of this manuscript is to systematically review the state of the art of necitumumab for the treatment of metastatic NSCLC, focusing on predictive factors, cost-effectiveness, and future potential combinations with additional agents. Expert opinion: Despite recent therapeutic advances, platinum-based chemotherapy still represents the most widely used first-line treatment for advanced NSCLC, particularly for the squamous histotype. Necitumumab is nowadays the first targeted agent providing an (statistically significant) additional survival gain to squamous NSCLC patients when combined with first-line chemotherapy at the cost of an increased (although manageable) toxicity, as shown in the SQUIRE trial. Hopefully, improvement in patients' selection by identifying reliable predictive markers and the combination with new agents may help to maximize the benefit of this targeted treatment, which is currently limited by a not optimal cost-benefit ratio.
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Affiliation(s)
- Vincenzo di Noia
- a U.O.C. Oncologia Medica , Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore , Roma , Italy
| | - Ettore D'Argento
- a U.O.C. Oncologia Medica , Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore , Roma , Italy
| | - Sara Pilotto
- b U.O.C. Oncology, Department of Medicine , University of Verona, Azienda Ospedaliera Universitaria Integrata , Verona , Italy
| | - Giulia Grizzi
- b U.O.C. Oncology, Department of Medicine , University of Verona, Azienda Ospedaliera Universitaria Integrata , Verona , Italy
| | - Mario Caccese
- b U.O.C. Oncology, Department of Medicine , University of Verona, Azienda Ospedaliera Universitaria Integrata , Verona , Italy
| | - Roberto Iacovelli
- b U.O.C. Oncology, Department of Medicine , University of Verona, Azienda Ospedaliera Universitaria Integrata , Verona , Italy
| | - Giampaolo Tortora
- b U.O.C. Oncology, Department of Medicine , University of Verona, Azienda Ospedaliera Universitaria Integrata , Verona , Italy
| | - Emilio Bria
- a U.O.C. Oncologia Medica , Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore , Roma , Italy
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Abstract
Eli Lilly is developing necitumumab (Portrazza™), an intravenously administered fully human IgG monoclonal antibody directed against the epidermal growth factor receptor (EGFR), which is expressed in a variety of solid tumours and has been implicated in promoting oncogenesis and tumour progression. Necitumumab is approved as a part of combination therapy (with gemcitabine and cisplatin) in the USA for the first-line treatment of metastatic squamous non-small cell lung cancer (NSCLC), and regulatory submissions have been made in the EU for this same indication. Necitumumab was derived from the proprietary phage display library of Dyax Corp, and originated with ImClone Systems, which was acquired by Eli Lilly in November 2008. Necitumumab was also under phase II development for colorectal cancer in Belgium and Spain; however, no recent development has been reported for this indication. This article summarizes the milestones in the development of necitumumab leading to this first approval for the first-line treatment of metastatic squamous NSCLC, in combination with gemcitabine and cisplatin.
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Greillier L, Tomasini P, Barlesi F. Necitumumab for non-small cell lung cancer. Expert Opin Biol Ther 2015; 15:1231-9. [DOI: 10.1517/14712598.2015.1055243] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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