The Right Partner in Crime: Unlocking the Potential of the Anti-EGFR Antibody Cetuximab via Combination With Natural Killer Cell Chartering Immunotherapeutic Strategies

Front Immunol. 2021 Sep 7:12:737311. doi: 10.3389/fimmu.2021.737311. eCollection 2021.

Abstract

Cetuximab has an established role in the treatment of patients with recurrent/metastatic colorectal cancer and head and neck squamous cell cancer (HNSCC). However, the long-term effectiveness of cetuximab has been limited by the development of acquired resistance, leading to tumor relapse. By contrast, immunotherapies can elicit long-term tumor regression, but the overall response rates are much more limited. In addition to epidermal growth factor (EGFR) inhibition, cetuximab can activate natural killer (NK) cells to induce antibody-dependent cellular cytotoxicity (ADCC). In view of the above, there is an unmet need for the majority of patients that are treated with both monotherapy cetuximab and immunotherapy. Accumulated evidence from (pre-)clinical studies suggests that targeted therapies can have synergistic antitumor effects through combination with immunotherapy. However, further optimizations, aimed towards illuminating the multifaceted interplay, are required to avoid toxicity and to achieve better therapeutic effectiveness. The current review summarizes existing (pre-)clinical evidence to provide a rationale supporting the use of combined cetuximab and immunotherapy approaches in patients with different types of cancer.

Keywords: antibody-mediated cellular cytotoxicity (ADCC); cetuximab; combination therapy; epidermal growth factor receptor (EGFR); immunotherapy; natural killer cells (NK cells).

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antibody-Dependent Cell Cytotoxicity / drug effects
  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cetuximab / adverse effects
  • Cetuximab / therapeutic use*
  • Colorectal Neoplasms / immunology
  • Colorectal Neoplasms / metabolism
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / therapy*
  • Cytokines / therapeutic use
  • ErbB Receptors / antagonists & inhibitors
  • ErbB Receptors / metabolism
  • Head and Neck Neoplasms / immunology
  • Head and Neck Neoplasms / metabolism
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Immunotherapy, Adoptive* / adverse effects
  • Killer Cells, Natural / drug effects*
  • Killer Cells, Natural / immunology
  • Killer Cells, Natural / metabolism
  • Killer Cells, Natural / transplantation*
  • Signal Transduction
  • Squamous Cell Carcinoma of Head and Neck / immunology
  • Squamous Cell Carcinoma of Head and Neck / metabolism
  • Squamous Cell Carcinoma of Head and Neck / secondary
  • Squamous Cell Carcinoma of Head and Neck / therapy*
  • Treatment Outcome
  • Tumor Escape / drug effects

Substances

  • Antineoplastic Agents, Immunological
  • Cytokines
  • EGFR protein, human
  • ErbB Receptors
  • Cetuximab