PURPOSE OF REVIEW: The epidermal growth factor receptor (EGFR) is overexpressed 
in many nonsmall cell lung cancers (NSCLCs). Blockade of EGFR by monoclonal 
antibodies has been studied as a strategy to improve the outcome of first-line 
chemotherapy in patients with NSCLC. The present review updates the findings 
from phase III trials.
RECENT FINDINGS: Cetuximab improved survival when combined with first-line 
chemotherapy and this benefit was limited to patients with high EGFR expression 
in their tumors. A Southwest Oncology Group study currently prospectively 
evaluates the predictive biomarkers for cetuximab. In the SQUIRE phase III 
trial, necitumumab added to cisplatin and gemcitabine increased the survival in 
patients with advanced squamous cell NSCLC. The INSPIRE trial studied 
chemotherapy with and without necitumumab in patients with nonsquamous NSCLC but 
was prematurely halted because of increased thromboembolic events with 
chemotherapy and necitumumab.
SUMMARY: EGFR monoclonal antibodies improved the outcome including survival in 
selected patients with advanced NSCLC. Prospective validation of predictive 
biomarkers is ongoing.