Erlotinib: In Advanced Pancreatic Cancer

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▴ Erlotinib is an orally administered quinazoline derivative that targets and inhibits the epidermal growth factor receptor (EGFR) tyrosine kinase enzyme, thereby disrupting signalling pathways that encourage cell growth and inhibit apoptosis.▴ In a phase III, randomized, double-blind, placebo-controlled trial in chemotherapy-naive patients with locally advanced, unresectable or metastatic pancreatic cancer, overall (6.4 vs 6.0 months; p = 0.028) and progression-free (3.8 vs 3.5 months; p = 0.006) survival times were significantly prolonged when erlotinib (100 mg/day) was coadministered with intravenous gemcitabine compared with the gemcitabine regimen alone. Tumor response (9% vs 8%) and disease stabilization (48% vs 41%) rates in this trial were similar between groups.▴ For erlotinib administered with capecitabine in previously treated patients with advanced pancreatic cancer, there was an 11% response rate and a 57% disease stabilization rate in a noncomparative phase II trial.▴ The most frequently reported adverse events (any grade) in the phase III trial in patients with pancreatic cancer receiving erlotinib and gemcitabine were fatigue, rash, and gastrointestinal disturbances; rash and diarrhea occurred with a numerically greater incidence in erlotinib plus gemcitabine recipients than in placebo plus gemcitabine recipients.

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