Cetuximab is a monoclonal antibody that targets the epidermal growth factor receptor (EGFR). Researchers in the USA have now used it in combination with gemcitabine, an established anti-cancer drug, to treat patients with epidermal growth receptor-expressing advanced pancreatic cancer.
In a multicenter phase II clinical trial, Henry Q. Xiong and colleagues have determined the response rate, time to disease progression, survival duration and rate and toxicity, with the combination of cetuximab and gemcitabine in patients with EGFR-expressing advanced pancreatic cancer.
The researchers recruited patients with measurable locally advanced or metastatic pancreatic cancer. All subjects had never received chemotherapy for their advanced disease and had immunohistochemical evidence of EGFR expression.
Patients were treated with cetuximab at an initial dose of 400 mg/m2. This was followed by 250 mg/m2 weekly for 7 weeks.
| Cetuximab with Gemcitabine for EGFR-expressing pancreatic cancer:
5 patients – partial response
26 patients – stable disease
|Journal of Clinical Oncology|
Gemcitabine was administered at 1000 mg/m2 for 7 weeks, followed by 1 week of rest.
In subsequent cycles, cetuximab was administered weekly, and gemcitabine was administered weekly for 3 weeks every 4 weeks.
A total of 61 patients were screened for EGFR expression, with 58 patients (95%) having at least 1 plus staining and being recruited onto the trial.
Five patients (12%) achieved a partial response, and 26 (63%) had stable disease.
The median time to disease progression was 3.8 months, with median overall survival duration of 7.1 months.
The researchers found that one-year progression-free survival and overall survival rates were 12% and 31.7%, respectively.
The most frequently reported grade 3 or 4 adverse events were neutropenia, which occurred in 39% of cases, asthenia (22%), abdominal pain (22%) and thrombocytopenia (17.%).
The authors conclude, "Cetuximab in combination with gemcitabine showed promising activity against advanced pancreatic cancer."
They add, however, that, "Further clinical investigation is warranted."