TH-302 + Gemcitabine (G + T) vs Gemcitabine (G) in Patients with Previously Untreated advanced Pancreatic Cancer (PAC)

Targeted therapies in medical oncology: successes, failures and next steps

“…Pancreatic cancer is known to be one of the most hypoxic solid tumours. Thus, TH-302 has been investigated in a phase IIb study of 214 previously untreated patients with locally advanced, unresectable or metastatic pancreatic cancer (median age 65 years) [Borad et al 2012]. Patients randomly received TH-302 240 mg/m 2 plus gemcitabine, TH-302 340 mg/m 2 plus gemcitabine or gemcitabine alone (administered on days 1, 8 and 15 of a 28-day cycle).…”

“…Signs that a strategy of selecting patients for specific treatments will be successful were presented by Dr Bruno Daniele (Rummo Hospital, Benevento, Italy) who presented the final results from the phase II trial of second-line tivantinib (ARQ 197, a MET inhibitor) in unresectable HCC. There were 107 patients (PS < 2, Child–Pugh A) randomized in a 2:1 ratio to receive tivantinib or placebo [Daniele et al . 2012].…”

“…The evidence presented at the 2012 European Society of Medical Oncology Congress (Vienna, 28 September–2 October 2012) adds to the move towards selecting patients for specific drug treatments based on elucidating biomarkers that reveal susceptible mutations or pathways. Epidermal growth factor receptor (EGFR) and KRAS mutations are well-known examples of this approach, and evidence presented at the congress corroborated this strategy across many cancer types: for example, the efficacy of tivantinib in MET-positive patients with hepatocellular carcinoma (HCC) [Daniele et al . 2012], crizotinib in anaplastic lymphoma kinase (ALK)-positive patients with nonsmall cell lung cancer (NSCLC) [Shaw et al .…”