Cetuximab: Brands, Price & Uses in Bangladesh

Established (FDA-approved) indications

• RAS wild-type, EGFR-expressing metastatic colorectal cancer (mCRC) (confirmed by an FDA-approved RAS mutation test), used:
  • in combination with FOLFIRI as first-line treatment;
  • in combination with irinotecan in patients who are refractory to irinotecan-based chemotherapy;
  • as a single agent in patients who have failed oxaliplatin- and irinotecan-based chemotherapy or who are intolerant to irinotecan.
• BRAF V600E-mutant metastatic colorectal cancer: Cetuximab in combination with encorafenib, after prior therapy, in patients with a confirmed BRAF V600E mutation.
• Squamous cell carcinoma of the head and neck (SCCHN), used:
  • in combination with radiation therapy for locally or regionally advanced disease;
  • in combination with platinum-based chemotherapy plus fluorouracil for recurrent locoregional disease or metastatic disease;
  • as a single agent for disease that has recurred or progressed after platinum-based chemotherapy.

Important: Cetuximab is not indicated for colorectal cancer with RAS mutations (KRAS or NRAS) or when RAS mutation status is unknown, and RAS/BRAF testing must be performed before starting therapy for colorectal cancer. Cetuximab must be prescribed and administered only under the supervision of a qualified oncology specialist.

General principles

Cetuximab is administered only by intravenous infusion under the supervision of a physician experienced in the use of antineoplastic agents, with immediate access to equipment and medication needed to manage severe infusion reactions. Premedication with an H1-antihistamine (e.g., diphenhydramine 50 mg IV) is required 30–60 minutes before the first dose and is recommended before subsequent doses.

See Dosage and Administration sections for further detail, and Precautions and Warnings for dose-modification rules related to infusion reactions and dermatologic toxicity.

Common adverse reactions

Serious adverse reactions

Serious and sometimes fatal infusion reactions, cardiopulmonary arrest/sudden death (particularly with concurrent radiotherapy in head and neck cancer), severe dermatologic toxicity with risk of infection, interstitial lung disease, and severe electrolyte depletion (hypomagnesemia, hypocalcemia, hypokalemia) can occur — see Precautions and Warnings for details.