First-line therapy for advanced pancreatic cancer with gemcitabine and docetaxel versus gemcitabine and erlotinib: A multivariate matched pair analysis.

Stuebs, Patrick; Habermann, P.; Zierau, K.; Schuette, K.; Fahlke, J.; Ridwelski, K.; Kettner, E.; Lippert, H.

doi:10.1200/jco.2010.28.15_suppl.e14572

Cited by 2 publications

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“…Patients with skin rashes during treatment with erlotinib had better overall survival than the patients with fewer or no rashes [103, 104]. Combination of erlotinib (100 mg/day) with gemcitabine (1,000 mg/m 2 ) did not show any benefit in overall survival rate compared with gemcitabine (1,000 mg/m 2 ) combined with docetaxel (35 mg/m 2 ) in a phase II study from 69 metastatic pancreatic cancer patients [106]. In a phase III study, erlotinib (150 mg/day) was given to 141 patients combined either with gemcitabine (1,000 mg/m 2 /week for 7 weeks), or capecitabine (2,000 mg/m 2 /day, day 1–14 every three weeks) until disease progression or toxicity appeared (TIF1).…”

Section: Introductionmentioning

confidence: 99%

Molecular Targeted Approaches for Treatment of Pancreatic Cancer

Huang¹,

Saluja²,

Dudeja³

et al. 2011

CPD

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Human pancreatic cancer remains a highly malignant disease with almost similar incidence and mortality despite extensive research. Many targeted therapies are under development. However, clinical investigation showed that single targeted therapies and most combined therapies were not able to improve the prognosis of this disease, even though some of these therapies had excellent anti-tumor effects in pre-clinical models. Cross-talk between cell proliferation signaling pathways may be an important phenomenon in pancreatic cancer, which may result in cancer cell survival even though some pathways are blocked by targeted therapy. Pancreatic cancer may possess different characteristics and targets in different stages of pathogenesis, maintenance and metastasis. Sensitivity to therapy may also vary for cancer cells at different stages. The unique pancreatic cancer structure with abundant stroma creates a tumor microenvironment with hypoxia and low blood perfusion rate, which prevents drug delivery to cancer cells. In this review, the most commonly investigated targeted therapies in pancreatic cancer treatment are discussed. However, how to combine these targeted therapies and/or combine them with chemotherapy to improve the survival rate of pancreatic cancer is still a challenge. Genomic and proteomic studies using pancreatic cancer samples obtained from either biopsy or surgery are recommended to individualize tumor characters and to perform drug sensitivity study in order to design a tailored therapy with minimal side effects. These studies may help to further investigate tumor pathogenesis, maintenance and metastasis to create cellular expression profiles at different stages. Integration of the information obtained needs to be performed from multiple levels and dimensions in order to develop a successful targeted therapy.

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Section: Introductionmentioning

confidence: 99%

Molecular Targeted Approaches for Treatment of Pancreatic Cancer

Huang¹,

Saluja²,

Dudeja³

et al. 2011

CPD

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Gemcitabine Plus Erlotinib for Advanced Pancreatic Cancer: A Systematic Review with Meta-Analysis

Yang

Yuan

et al. 2013

PLoS ONE

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BackgroundThis study aims to comprehensively summarize the currently available evidences on the efficacy and safety of gemcitabine plus erlotinib for treating advanced pancreatic cancer.Methodology/Principal FindingsPubMed, EMBASE, The Cochrane Library and abstracts of recent major conferences were systematically searched to identify relevant publications. Studies that were conducted in advanced pancreatic cancer patients treated with gemcitabine plus erlotinib (with or without comparison with gemcitabine alone) and reporting objective response rate, disease control rate, progression-free survival, time-to-progression, overall survival, 1-year survival rate and/or adverse events were included. Data on objective response rate, disease control rate, 1-year survival rate and adverse events rate, respectively, were combined mainly by using Meta-Analyst software with a random-effects model. Data on progression-free survival, time-to-progression and overall survival were summarized descriptively. Sixteen studies containing 1,308 advanced pancreatic cancer patients treated with gemcitabine plus erlotinib were included. The reported median progression-free survival (or time-to-progression), median overall survival, 1-year survival rates, objective response rates and disease control rates were 2–9.6 months, 5–12.5 months, 20%–51%, 0%–28.6% and 25.0%–83.3%, respectively. The weighted 1-year survival rate, objective response rate and disease control rate based on studies reporting robust results were 27.9%, 9.1% and 57.0%, respectively. According to the studies with relevant data, the incidences of total and severe adverse events were 96.3% and 62.9%, respectively. The most frequently reported adverse events were leucopenia, rash, diarrhea, vomitting, neutropenia, thrombocytopenia, anaemia, stomatitis, drug-induced liver injury, fatigue and fever. Compared with gemcitabine alone, the progression-free survival and overall survival with gemcitabine plus erlotinib were significantly longer, but there were also more deaths and interstitial lung disease-like syndrome related to this treatment.Conclusions/SignificanceGemcitabine plus erlotinib represent a new option for the treatment of advanced pancreatic cancer, with mild but clinically meaningful additive efficacy compared with gemcitabine alone. Its safety profile is generally acceptable, although careful management is needed for some specific adverse events.

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First-line therapy for advanced pancreatic cancer with gemcitabine and docetaxel versus gemcitabine and erlotinib: A multivariate matched pair analysis.

Cited by 2 publications

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Molecular Targeted Approaches for Treatment of Pancreatic Cancer

Molecular Targeted Approaches for Treatment of Pancreatic Cancer

Gemcitabine Plus Erlotinib for Advanced Pancreatic Cancer: A Systematic Review with Meta-Analysis

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