Cetuximab Every 2 Weeks Versus Standard Weekly Dosing Administration Schedule

Abstract

Cetuximab every 2 weeks (Q2W) dosing schedule is approved by the US FDA and by the Japanese Pharmaceuticals and Medical Devices Agency in patients with metastatic colorectal cancer and squamous cell carcinoma of the head and neck. Phase II trials have found comparable efficacy and safety for the weekly (Q1W) and Q2W schedules, and real-world studies have shown noninferiority of the Q2W compared with the Q1W schedule. Several guidelines recommend cetuximab Q2W administration as an alternative to the Q1W dosing schedule. Cetuximab Q2W can be administered with a Q2W dose of chemotherapy, making it a more convenient option to the Q1W schedule, potentially resulting in reduced costs for administration, increased flexibility for clinical staff and improved patient adherence.

Plain Language Summary

Every 2 weeks dosing schedule of cetuximab is a convenient alternative to the weekly schedule

Cetuximab is a drug for patients with colorectal cancer or cancer of the head and neck. It is usually administered once a week. However, studies have shown that cetuximab given once every 2 weeks instead has similar clinical benefits and side effects. Based on this evidence, the every 2 weeks dosing schedule has been approved for use in USA and Japan. The every 2 weeks dosing schedule is a convenient alternative to the weekly schedule. It may result in fewer hospital visits, improved patient quality of life, reduced healthcare costs and more flexibility for medical staff. This review summarizes the current evidence and benefits for the every 2 weeks dosing schedule.

Tweetable abstract

A review highlights comparable pharmacokinetics, efficacy and safety data reported for #cetuximab #every2weeks and weekly dosing schedules.

Keywords::

• cetuximab
• dosing schedule
• efficacy
• every 2 weeks
• pharmacokinetics
• safety

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/fon-2023-0282

Author contributions

All authors contributed equally to the writing of the manuscript, and reviewed and approved the final draft. J Tabernero and S Kasper contributed to data provision and analysis. C Bokemeyer contributed to the conceptual design of the manuscript and manuscript improvement. P Pfeiffer contributed to the conception, analysis and interpretation of data.

Financial disclosure

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

CB reports grants or contracts (institution)from Abbvie, ADC Therapeutics, Agile Therapeutics, Alexion Pharmaceuticals, Amgen, Apellis Pharmaceuticals, Astellas Pharma, AstraZeneca, Bayer, BerGenBio, Blueprint Medicines, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Daiichi Sankyo, Eisai, Gilead Sciences, Glycotope GmbH, GlaxoSmithKline, Incyte, IO Biotech, Isofol Medical, Janssen-Cilag, Karyopharm Therapeutics, Lilly, Millennium, MSD, Nektar, Novartis, Rafael Pharmaceuticals, Roche, Springworks Therapeutics, Taiho Pharmaceutical; payments or honoraria (self) from Merck KGaA, Sanofi, Roche, Bayer, Bristol-Myers Squibb, AstraZeneca, Merck Sharp Dohme, GSO, AOK Health Insurance, Novartis; support for attending meetings and/or travel from Bayer, Roche and BMS; leadership or fiduciary role in Hamburg Cancer Society and German Sociery of Hematology and Oncology. FC reports grants or contracts from Roche, Pfizer and Pierre Fabre; payment or honoraria from Merck KGaA, Bayer, Pierre Fabre, Servier, MSD and Roche. OD outside the submitted work personal fees for advisory role, speaker engagements and travel and accommodation expenses from Merck, Amgen, Roche, and Lilly; advisory/consultancy roles with Ipsen, Merck, Amgen-Serono, MSD, Mylan, Novartis, Roche, Sanofi, Aventis, Servier, and Lilly; research grants/funding (self) from Merck and Lilly; research grants/funding (institution) from Merck and Lilly; travel/accommodation expenses from Merck, Amgen, Roche, Sanofi, Aventis, Servier, and Lilly. JG reports outside the submitted work personal fees for advisory role with BMS, Hookipa Pharma, Merck KGaA, Merck SD, Nanobiotix; and research grants/funding (institution) from Merck Serono, Chugai, Sandoz. SK reports honoraria (self) from Merck Serono, Amgen, Roche, Sanofi, Aventis, Servier, and Lilly; honoraria (institution) from Merck, Amgen, Roche, and Lilly; advisory/consultancy roles with Merck, BMS, MSD, Amgen, Roche, Sanofi, Aventis, Servier, and Lilly; research grants/funding (self) from Merck, Roche, BMS and Lilly; research grants/funding (institution) from Merck and Lilly; travel/accommodation expenses from Merck, Amgen, Roche, Sanofi, Aventis, Servier, and Lilly. PP reports reports investigator-initiated trials in collaboration with Merck Serono. CP reports outside the submitted work personal fees for advisory role, speaker engagements and travel and accommodation expenses from Amgen, Astellas, AstraZeneca, Bayer, BMS, Celgene, Clovis Oncology, Eisai, Ipsen, Janssen, Incyte, Merck Serono, MSD, Novartis, Roche, Sandoz, Sanofi, Aventis, Servier, and Lilly; honoraria (institution) KY reports grants or contracts (institution) from Taiho Pharmaceutical, Yakult Honsha, Ono Pharmaceutical; payment or honoraria (self) from Taiho Pharmaceutical, Daiichi Sankyo, Ono Pharmaceutical, Bristol Myers Squibb and Elly Lilly Japan. TY reports honoraria from Taiho Pharmaceutical, Chugai Pharmaceutical, Eli Lilly, Merck Biopharma, Bayer Yakuhin, Ono Pharmaceutical, and MSD; and research funding from Ono Pharmaceutical, Sanofi, Daiichi Sankyo, PAREXEL International, Pfizer Japan, Taiho Pharmaceutical, MSD, Amgen, Genomedia, Sysmex, Chugai Pharmaceutical, and Nippon Boehringer Ingelheim CZ reports grants or contracts (self) from Athenex, Elsevier as Editor in Chief of ESMO Open – Cancer Horizons; consulting fees from Anthenex; payment or honoraria from MSD, Imugene, AstraZeneca, Servier and Eli Lilly; patents planned, issues or pending from Imugene. RE was employed by Merck Healthcare KGaA at the time of the manuscript development and discloses stock ownership in Merck KGaA, Darmstadt, Germany. The author is no longer an employee of Merck Healthcare KGaA. JT reports personal financial interest in the form of a scientific consultancy role for Array Biopharma, AstraZeneca, Avvinity, Bayer, Boehringer Ingelheim, Chugai, Daiichi Sankyo, F. Hoffmann-La Roche Ltd, Genentech Inc, HalioDX SAS, Hutchison MediPharma International, Ikena Oncology, Inspirna Inc., IQVIA, Lilly, Menarini, Merck Serono, Merus, MSD, Mirati, Neophore, Novartis, Ona Therapeutics, Orion Biotechnology, Peptomyc, Pfizer, Pierre Fabre, Samsung Bioepis, Sanofi, Seattle Genetics, Scandion Oncology, Servier, Sotio Biotech, Taiho, Tessa Therapeutics and TheraMyc; and educational collaboration with Imedex/HMP, Medscape Education, MJH Life Sciences, PeerView Institute for Medical Education and Physicians Education Resource (PER). The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

Medical writing support was provided by Aleksandra Erac-Zganec of Nucleus Global and was funded by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945), in accordance with Good Publication Practice (GPP) guidelines (https://www.ismpp.org/gpp-2022).

Additional information

Funding

Medical writing support was provided by Aleksandra Erac-Zganec of Nucleus Global and was funded by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945), in accordance with Good Publication Practice (GPP) guidelines (https://www.ismpp.org/gpp-2022).