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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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Shum E, Wang F, Kim S, Perez-Soler R, Cheng H. Investigational therapies for squamous cell lung cancer: from animal studies to phase II trials. Expert Opin Investig Drugs 2017; 26:415-426. [PMID: 28277882 DOI: 10.1080/13543784.2017.1302425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION It remains challenging to treat squamous cell lung cancer (SCC) with limited therapeutic options. However, recent breakthroughs in targeted therapies and immunotherapies have shed some light on the management of this deadly disease. Areas covered: The article first reviews the current treatment options for advanced SCC, especially recent FDA approved molecular agents (afatinib, ramucirumab and necitumumab) and immunotherapies (nivolumab, pembrolizumab and atezolimumab). We then provide an overview on investigational therapies with data ranging from preclinical to phase II studies, focusing on new cytotoxic agents, emerging molecularly targeted agents (including a PARP inhibitor for Homologous Recombinant Deficiency positive SCC) and novel immunotherapeutic strategies. Expert opinion summary: Identification of potential therapeutic targets, development of novel clinical trials and the rapid approvals of immune checkpoint inhibitors have shifted the management paradigm for squamous cell lung cancer. On the other hand, continued efforts are needed to identify the predictive biomarkers and to investigate novel mechanistically-driven mono- and combination therapies. We need to learn more about the biology behind immune checkpoint blockade and tumor genomics in SCC for better patient selection and future trial design.
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Affiliation(s)
- Elaine Shum
- a Department of Oncology , Montefiore Medical Center/Albert Einstein College of Medicine , Bronx , NY , USA
| | - Feng Wang
- a Department of Oncology , Montefiore Medical Center/Albert Einstein College of Medicine , Bronx , NY , USA
| | - Salem Kim
- a Department of Oncology , Montefiore Medical Center/Albert Einstein College of Medicine , Bronx , NY , USA
| | - Roman Perez-Soler
- a Department of Oncology , Montefiore Medical Center/Albert Einstein College of Medicine , Bronx , NY , USA
| | - Haiying Cheng
- a Department of Oncology , Montefiore Medical Center/Albert Einstein College of Medicine , Bronx , NY , USA
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