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Response to GEMOX plus erlotinib in pancreatic cancer is associated with ERCC 1 overexpression
Author(s) -
Fuereder Thorsten,
Stift Judith,
Kuehrer Irene,
Stranzl Nadja,
Hoeflmayer Doris,
Kornek Gabriela,
Scheithauer Werner
Publication year - 2014
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12329
Subject(s) - medicine , erlotinib , gemcitabine , oxaliplatin , gastroenterology , oncology , cancer , colorectal cancer , epidermal growth factor receptor
Abstract Introduction There are no data about the efficacy of gemcitabine in combination with oxaliplatin ( GEMOX ) and erlotinib for the treatment of metastatic pancreatic cancer ( mPC ). Thus, we performed this retrospective analysis in mPC patients to investigate the activity and safety of GEMOX plus erlotinib and correlated the benefit with ERCC 1 expression, a potential biomarker for treatment response. Patients and methods Patients with untreated mPC receiving off‐protocol GEMOX plus erlotinib were included. Data collection included baseline demographic, response and toxicity data as well as PFS and OS . Additionally, immunohistochemistry was performed to stain for ERCC 1 expression. Results A total of 51 patients were included. The median age was 62 years and the median ECOG performance score was 1 (range, 0–1). Objective response or disease stabilization was achieved in 54% of the patients. The median PFS was 4·4 months (95% CI 4·4–5·4) and median OS was 8·5 months (95% CI 6·1–10·9). The 27 patients, who benefited from this regimen, had a median PFS of 6·7, a median OS of 11·2 months and an overexpression of ERCC 1 (histoscore 10, P ≤ 0·05) compared to nonresponders (histoscore 7·2). Myelosuppression was the most frequent side effect. The most common severe nonhematological toxicities were diarrhoea and skin toxicity in six (12%) patients each. Conclusions These data suggest that the combination of GEMOX plus erlotinib is safe and active in about half of the patients. Patients, who had a higher ERCC 1 staining pattern, benefited most from this therapy. Prospective biomarker studies are warranted to confirm these findings.