Following a resubmission, the Scottish Medicines Consortium (SMC) has accepted cetuximab (Erbitux®) for restricted use within NHS Scotland for the treatment of patients with epidermal growth factor receptor (EGFR)-expressing, Kirsten rat sarcoma (KRAS) wild-type metastatic colorectal cancer in combination with chemotherapy.

The drug advice notes that the addition of cetuximab to standard first-line chemotherapy increased overall response, with a small increase in median progression-free survival, in patients with KRAS wild-type status who had not previously received chemotherapy for metastatic disease (post-hoc analyses).

Cetuximab is restricted to use in patients who have not previously received chemotherapy for their metastatic disease, with liver metastases only that are considered non-resectable but in whom potentially curative liver metastasis resection would be undertaken if the lesions became resectable after treatment with chemotherapy and cetuximab.

This advice takes account of a Patient Access Scheme that improves the cost-effectiveness of cetuximab, and is therefore dependent upon its continuing availability in NHS Scotland.