768 - Gemox plus erlotinib for the treatment of metastatic pancreatic adenocarcinoma

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Presenter Thorsten Füreder
Authors T. Füreder1, G.V. Kornek1, I. Kührer2, C. Zielinski3, J. Klech1, W. Scheithauer4
  • 1Internal Medicine I, Medical University of Vienna, 1090 - Vienna/AT
  • 2Surgery, Medical University of Vienna, 1090 - Vienna/AT
  • 3Department Of Medicine I, Medical University of Vienna and Central European Cooperative Oncology Group (CECOG), A-1090 - Vienna/AT
  • 4Oncology, Medical University of Vienna, 1090 - Vienna/AT

Abstract

Introduction

Based on demonstration of a significant improvement in overall survival in a placebo-controlled phase III trial, gemcitabine in combination with erlotinib has been approved for the treatment of metastatic pancreatic cancer. In patients with good performance status, gemcitabine combination chemotherapy, i.e. with oxaliplatin (GEMOX) is commonly being used. Although there is some evidence that GEMOX plus erlotinib is beneficial in a subgroup of patients compared to GEMOX alone in cholangiocellular carcinoma no such data exist for pancreatic cancer. Thus, we performed this retrospective analysis in unselected patients to investigate the efficacy and safety of this chemotherapy regimen.

Patients and methods

Forty-four patients with metastatic adenocarcinoma of the pancreas receiving off-protocol GEMOX in combination with erlotinib at a single institution between January 2006 and September 2011 were included in this analysis. Data collection included baseline demographic, clinical and toxicity data as well as objective response according to RECIST criteria, progression-free survival (PFS) and overall survival (OS).

Results

A total of 44 patients were included in this study. The mean age was 60.5 years, and the median ECOG performance score was 1 (range, 0-1). GEMOX in combination with erlotinib was first line regimen in 84% of the patients. Clinical response and disease stabilization was achieved in 45% of the patients. The median PFS was 4 months (range 0.5-43) and median overall survival was 9.6 months (range 0.7-54.7). However, the subgroup of 20 patients, who benefited from this regimen in terms of abrogation of progression, had a PFS of 11.2 and an OS of 15.4 months. Myelosuppression was the most frequent side effect. The most common severe nonhematological toxicity was diarrhea (5/44).

Conclusions

These data suggest that the combination of GEMOX plus erlotinib is safe and active in about half of the patients treated with this regimen. Identification of (bio)markers would be desirable in order to be able to select patients, who are most likely to benefit from this therapeutic strategy.

Disclosure

All authors have declared no conflicts of interest.