Cancer Clinical Trial
Official title:
Phase II Trial of Erlotinib in Advanced Pancreatic Cancer
This is an open-label, multi-center phase II study of erlotinib in patients with metastatic or locally advanced, unresectable pancreatic cancer who have received up to one line of gemcitabine based chemotherapy.
Erlotinib in addition to gemcitabine significantly improves overall survival compared to
gemcitabine alone in advanced pancreatic cancer (median overall survival 6.24 vs 5.91 months
respectively). However, combined therapy has not become standard of care due to the modest
absolute benefit. In NSCLC, the optimal efficacy of erlotinib is not in combination with
first-line cytotoxic chemotherapy for advanced disease, but as a single agent after cytoxic
chemotherapy. Preclinical and clinical data suggest that erlotinib will have activity as a
single agent in advanced pancreatic cancer. The presence of an erlotinib-induced rash is
associated with improved survival in phase II and III trials of diverse tumor types (reviewed
by Perez-Soler et al.), and is associated with higher steady state concentrations of
erlotinib.
This phase II trial aims to determine the safety and efficacy of erlotinib in patients with
advanced pancreatic cancer who have previously been treated with up to one prior line of
gemcitabine based chemotherapy for advanced disease. In addition, we will evaluate the
feasibility and activity of dose escalation of erlotinib in patients who do not develop a
rash. Clinical outcome will be correlated to EGFR status based on immunohistochemistry and
gene amplification status as well as Kras mutations from archival tumor tissue.
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