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Cetuximab plus chemotherapy is a combination treatment strategy being evaluated by Fudan University for the management of RAS wild-type colorectal cancer liver metastases (CRCLM). This approach, often referred to as a 'cetuximab rechallenge,' involves the re-administration of cetuximab—a chimeric IgG1 monoclonal antibody that targets the epidermal growth factor receptor (EGFR)—to patients who previously responded to cetuximab-based first-line therapy but subsequently progressed. The cetuximab is combined with standard chemotherapy regimens, such as FOLFOX (fluorouracil, leucovorin, and oxaliplatin) or FOLFIRI (fluorouracil, leucovorin, and irinotecan). The rationale behind this strategy is that a period of withdrawal from EGFR inhibitors (during second-line therapy) may restore the sensitivity of the tumor to cetuximab, a process that can be monitored using circulating tumor DNA (ctDNA) to confirm the absence of RAS mutations.
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