The Cost and Value of Anti–Epidermal Growth Factor Receptor Therapies

I don't treat any of my patients with RAS wild-type colorectal cancer with first-line cetuximab- or panitumumab-containing regimens. I don't think you should either. Here's why. The skin rash from use of anti– epidermal growth factor receptor (EGFR) monoclonal antibodies is miserable, and the cost per dose is roughly double that of bevacizumab. Furthermore, anti-EGFR agents can be used in therapies other than first line to provide survival benefit to patients with RAS wild-type cancer, so their unpleasant adverse effects can be delayed until other, less noxious treatment options have been exhausted. Even if the data convincingly showed a modest sur