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Biological therapies for bowel cancer

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This page tells you about biological therapy for bowel cancer (colorectal cancer). You can find the following information

 

A quick guide to what's on this page

Biological therapies for bowel cancer

Biological therapies are drugs that help the body to control the growth of cancer cells. Doctors may use some types of biological therapies to treat colon or rectal cancer that has spread to another part of the body.

Cetuximab (Erbitux) is a type of biological therapy called a monoclonal antibody. It is used to treat some people with bowel cancer that has spread. You can only have this treatment if your cancer has a normal copy of a gene called k-ras. You usually have it with the chemotherapy drugs 5FU (fluorouracil), oxaliplatin, or irinotecan. 

The monoclonal antibodies bevacizumab (Avastin) and panitumumab (Vectibix), and another type of biological therapy called aflibercept are also licensed in the UK for advanced colorectal cancer. Aflibercept works by stopping cancer cells from making their own blood supply (anti angiogenic drug). These drugs are generally not available on the NHS, but doctors in England may be able to fund bevacizumab and aflibercept through the Cancer Drugs Fund.

Some of the most common side effects of these drugs include tiredness, diarrhoea, sore mouth, loss of appetite, low blood counts and feeling sick.

Researchers are testing other types of biological therapy in trials for bowel cancer. And research is also looking into combining biological therapies with chemotherapy to see if they work better together.

There is information about individual biological therapies and their side effects in our biological therapy section.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating bowel cancer section.

 

 

What biological therapy is

Biological therapies are drugs that can help the body to control the growth of cancer cells. Some types of biological therapies can be used to treat colon or rectal cancer that has spread to other parts of the body.

 

Cetuximab (Erbitux) for advanced bowel cancer

A biological therapy called cetuximab (Erbitux) is licensed in the UK for advanced bowel cancer. We know from research that it can help some people with advanced bowel cancer to live longer when they have it with standard chemotherapy treatment. It can also improve their quality of life. You usually have cetuximab with the chemotherapy drugs 5FU (fluorouracil), oxaliplatin, or irinotecan.

Cetuximab (Erbitux) is a type of monoclonal antibody. Some bowel cancer cells have receptors for a protein produced in the body called epidermal growth factor. This protein attaches to receptors on cancer cells and triggers them to grow. Cetuximab blocks epidermal growth factor (EGF). So it is called a growth factor blocker.

We know from recent research that between 3 and 4 out of every 10 advanced bowel cancers (35 to 40%) have a change (mutation) in a gene called k-ras. Cetuximab doesn't work for bowel cancers that have a k-ras mutation. So doctors can only use cetuximab to treat people whose cancer has a normal k-ras gene. If your doctor thinks that cetuximab could be a helpful treatment for you they will test your cancer cells first to see if they have a k-ras mutation.

For some people, cetuximab and chemotherapy may be able to shrink liver tumours so that they can be removed with surgery. In this situation you usually have cetuximab with FOLFOX or FOLFIRI chemotherapy. The treatment is for up to 16 weeks. Once you have finished the treatment, your doctors will check whether it will be possible to remove the cancer in your liver.

 

Other biological therapies for advanced bowel cancer

The monoclonal antibodies bevacizumab (Avastin) and panitumumab (Vectibix) are licensed for advanced bowel cancer. 

Aflibercept (Zaltrap) is another type of biological therapy. It works by stopping cancer cells from making their own blood supply (anti angiogenic drug). It is licensed for people with advanced bowel cancer, when the chemotherapy drug oxaliplatin is no longer working. You have aflibercept with FOLFIRI chemotherapy. 

These biological therapy drugs are generally not available on the NHS, but doctors in England may be able to fund bevacizumab and aflibercept through the Cancer Drugs Fund. In Scotland, the Scottish Medicines Consortium (SMC) have said aflibercept should be available on the NHS.

Some biological therapies are very new and it will be some time before we know how well they work. All new treatments have to go through the clinical trials process and this takes some years. Research is looking into using biological therapies alongside chemotherapy to see how they work best together. There is information about biological therapies in the bowel cancer research section.

To search for bowel cancer trials, visit our clinical trials database and select 'bowel' from the dropdown menu of cancer types.

 

Side effects of biological therapy

As with all drugs, biological therapies have side effects. Some of the most common side effects include


Tell your doctor if you have any side effects as you may be able to have medicines to help control them. There is detailed information about the side effects of cetuximab, bevacizumab, aflibercept and panitumumab in our cancer drugs section.

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Updated: 11 September 2013