Individual patient treatment requests: process and evaluation of the use of third-line single-agent cetuximab

Abstract

AimSingle agent cetuximab can be used as palliative treatment for chemo-refractory colorectal cancer (CRC). Although randomised trial data suggest its use is associated with enhanced progression-free and overall survival, access to the drug in Scotland was until recently limited. The aim of the study was to retrospectively review the authors' experience of gaining access to cetuximab, and the efficacy of the treatment for this patient group.MethodPatients with CRC were identified retrospectively from an electronic prescribing database. The authors reviewed the case sheets in relation to ease of access to the drug, toxicities and efficacy.ResultsTreatment was actively sought for 18 patients between 2010 and 2014, of whom nine were initially denied access to the drug, however ultimately 13 received the treatment. This group had a median survival of 15 months.ConclusionThere were challenges associated with accessing cetuximab through the system in place at the time of review. The drug has demonstrated considerable efficacy and only modest toxicity in this small retrospective series.