Which EGFR Ab preferred 1st as Tx for mCRC? Ever use other EGFR Ab later?

Which EGFR Ab preferred 1^st as Tx for mCRC? Ever use other EGFR Ab later?

Which EGFR antibody do you usually use first in the treatment of mCRC?

Do you usually use the other EGFR antibody at a later point in treatment?

	Steven R Alberts, MD, MPH
	Chair, Division of Medical Oncology Professor of Oncology Mayo Clinic Rochester, Minnesota

Answer: Cetuximab; Yes

I have treated 12 to 15 cases of mCRC with an EGFR antibody in the past year. My initial preference for an EGFR antibody is cetuximab. However, if the patient is responding to cetuximab but experiencing side effects such as allergic reactions, and if I have no other options, I will consider using panitumumab.

	Al B Benson III, MD
	Professor of Medicine Associate Director for Clinical Investigations Robert H Lurie Comprehensive Cancer Center of Northwestern University Chicago, Illinois

Answer: Cetuximab; No

In the past year, I’ve treated at least 20 cases of mCRC with cetuximab, which is my choice for an EGFR antibody. I would not consider using panitumumab at a later point.

	Charles S Fuchs, MD, MPH
	Director Center for Gastrointestinal Cancer Dana-Farber/Harvard Cancer Center Professor of Medicine Harvard Medical School Boston, Massachusetts

Answer: Cutuximab; Yes

I’ve treated several dozen cases of mCRC with an EGFR antibody in the past year. I usually administer cetuximab first, though I have used panitumumab. This year I switched 2 patients to panitumumab who developed mild hypersensitivity reactions to cetuximab. I have administered panitumumab to patients after cetuximab failure but have been unimpressed with the results.

	Richard M Goldberg, MD
	Professor of Medicine Physician-in-Chief, OSUCCC - James Cancer Hospital and Richard J Solove Research Institute Klotz Family Chair in Cancer Research The Ohio State University Columbus, Ohio

Answer: Panitumumab; No

In the past year, I’ve treated about 50 cases of mCRC with an EGFR antibody off protocol. I usually recommend panitumumab, for 3 reasons. First, I practiced in North Carolina for a long time and observed a lot of anaphylactic reactions to cetuximab. Second, cetuximab is administered weekly and panitumumab is administered every other week. Third, panitumumab is cheaper than cetuximab. I do not prescribe cetuximab for patients at a later point because I believe that the data suggesting that a patient would respond to one antibody after treatment with the other is weak.

	Axel Grothey, MD
	Professor of Oncology Department of Medical Oncology Mayo Clinic Rochester, Minnesota

Answer: Cetuximab; No

I have administered an EGFR antibody, usually cetuximab, to 40 patients with mCRC in the past year and I do not use panitumumab at a later point unless the patient experiences an allergic reaction to cetuximab.

	Howard S Hochster, MD
	Associate Director (Clinical Research) Yale Cancer Center Professor of Medicine Yale School of Medicine New Haven, Connecticut

Answer: Cetuximab; Yes

I’ve treated 8 cases of mCRC with an EGFR antibody, usually cetuximab, outside a protocol setting. I would consider using panitumumab for a patient at a later point.

	Herbert I Hurwitz, MD
	Associate Professor of Medicine Division of Hematology/Oncology Clinical Director, Phase I Program Co-leader, GI Oncology Program Duke University Medical Center Durham, North Carolina

Answer: Panitumumab; No

I’ve administered an EGFR antibody to about 20 patients off protocol in the past year.
I prefer panitumumab because of the infusion reactions associated with cetuximab. The evidence and convenience also would support the use of panitumumab. I would not use cetuximab at a later point outside of a trial setting.

	Wells A Messersmith, MD
	Professor and Director GI Medical Oncology Program Co-Leader Developmental Therapeutics Program University of Colorado Cancer Center Aurora, Colorado

Answer: Cetuximab; No

I’ve treated at least 10 cases of mCRC with cetuximab, which is my first choice for an EGFR antibody. I do not recommend panitumumab at a later point for a patient who has experienced disease progression on cetuximab because we do not have data to support that practice. Considering the increased attention on costs and the lessons learned from the past, we may do more harm when we adopt practice without supportive evidence.

First-Line Treatment