Necitumumab, a monoclonal antibody directed against EGFR, is currently under 
development as a treatment for advanced NSCLC. Two Phase III randomized trials 
are ongoing, testing the addition of necitumumab to first-line platinum-based 
chemotherapy. In the same setting, cetuximab produced a statistically 
significant but clinically modest benefit in the whole study population, and no 
solid data have been produced about predictive factors of efficacy. Will the 
difference in structure between the two antibodies be enough to obtain a 
clinically relevant advantage, making real progress in the treatment of advanced 
NSCLC? Large Phase III trials in unselected patients risk demonstrating 
statistically significant results with debatable clinical relevance in the whole 
population, and the study of predictive factors is often left to subgroup 
analysis performed after the conduction of the trial. We do not need further 
'me-too' drugs, or drugs that produce a small benefit in the unselected 
population. On the contrary, the oncologic community needs drugs to be used with 
a proper selection of patients, to obtain larger, relevant benefits in 
molecularly characterized subgroups. Final results of randomized trials with 
necitumumab in advanced NSCLC are expected in a couple of years.