Necitumumab for the treatment of stage IV metastatic squamous non-small-cell lung cancer

Abstract

Over the past two decades, progress in the treatment of patients with metastatic squamous non-small-cell lung cancer has been limited. The EGFR is involved in tumor progression and invasion and therefore it has become the target of several studies in lung cancer. Strategies to block this pathway are focused on the development of small molecule (tyrosine kinase inhibitor) and monoclonal antibodies (mAbs). Some mAbs have been studied in patients with advanced non-small-cell lung cancer. For the first time, a fully human immunoglobulin G (IMC-11F8), subclass 1 (IgG1) mAb targeting the EGFR, in combination with standard chemotherapy (cisplatin + gemcitabine), has been shown to increase overall survival in chemo-naïve patients with metastatic confirmed squamous cell histology.

Keywords:

• anti-EGFR
• monoclonal antibody
• NSCLC
• squamous
• target therapy

Financial & competing interests disclosure

C Gridelli receives honoraria as member of speaker bureau and advisory board for Eli Lilly. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Squamous histology accounts for 25–30% of non-small-cell lung cancer (NSCLC).

• Limited progress has been made when compared with non-squamous NSCLC due to the lack of relevant oncogenic drivers.

• The addition of cetuximab to platinum-based first-line therapy significantly improved efficacy in NSCLC.

• Necitumumab (IMC-11F8 is a human IgG1 anti-EGFR monoclonal antibody).

• SQUIRE is the largest randomized Phase III trial in the first-line treatment for metastatic squamous NSCLC.

• The study showed a statistically significant improvement in overall survival.

• Necitumumab combined with chemotherapy (gemcitabine–cisplatin) showed an acceptable safety profile.

• The SQUIRE results are an important advance in the search for a new treatment for patients with metastatic squamous NSCLC.