Cetuximab given with other drugs called 5-fluorouracil, folinic acid and oxaliplatin is recommended as a possible first treatment for people with metastatic colorectal cancer only when:

  • surgery to remove the cancer in the colon or rectum has been carried out or is possible
  • the metastases are only in the liver and cannot be removed surgically before treatment
  • the person is fit enough to have surgery to remove the cancer inthe colon or rectum and to have liver surgery if it becomes possible to remove the metastases after cetuximab treatment
  • the manufacturer refunds 16% of the amount of cetuximab used on a per patient basis.

Cetuximab given with 5-fluorouracil, folinic acid and irinotecan is recommended as a possible first treatment for people with metastatic colorectal cancer only when:

  • surgery to remove the cancer in the colon or rectum has been carried out or is possible
  • the metastases are only in the liver and cannot be removed surgically before treatment
  • the person is fit enough to have surgery to remove the cancer in the colon or rectum and to have liver surgery if it becomes possible to remove the metastases after cetuximab treatment
  • the person cannot take oxaliplatin because of its side effects or contraindications.

Treatment with cetuximab should stop after 16 weeks and the person should be assessed to see if they can have surgery to remove the metastases in their liver.

People with metastases only in the liver who receive cetuximab should have their treatment managed only by multidisciplinary teams that involve highly specialised liver surgical services.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

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