Blockade of the epidermal growth factor receptor (EGFR) by monoclonal antibodies 
is a strategy to improve outcome in patients with non-small cell lung cancer. 
Cetuximab, a chimeric anti-EGFR monoclonal antibody, has been studied in 
combination with different chemotherapy protocols in both phase II and phase III 
trials in patients with advanced NSCLC. In the phase III FLEX trial, cetuximab 
added to cisplatin/vinorelbine resulted in an absolute overall survival benefit 
of 1.2 months compared to the same chemotherapy alone in patients with advanced 
EGFR-expressing NSCLC. In the second phase III trial, cetuximab added to 
carboplatin plus paclitaxed failed to improve progression-free survival but 
suggested a survival benefit similar to that seen in the FLEX trial. However, 
the benefit in survival reached statistical significance only in the FLEX trial. 
A meta-analysis that included patients from four randomized trials confirmed the 
efficacy of cetuximab when added to chemotherapy. Thus addition of cetuximab to 
platinum-based chemotherapy represents a new treatment option for patients with 
advanced NSCLC. Matuzumab and panitumumab have also been evaluated in phase II 
trials. Necitumumab is currently evaluated in combination with chemotherapy in 
two randomized phase III trials.