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Frontline treatment with gemcitabine, oxaliplatin and erlotinib for the treatment of advanced or metastatic pancreatic cancer: a multicenter phase II study of the Hellenic Oncology Research Group (HORG)

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Abstract

Purpose

Intravenous gemcitabine is the standard of care for patients with metastatic cancer of the pancreas. Gemcitabine-based chemotherapy combinations, either doublets or triplets, have been tested in the past but have offered a small advantage (Brodoefel et al. in Eur J Radiol 73:594–600, 2010). In the present study, we present the results of the triplet gemcitabine–oxaliplatin–erlotinib combination as firstline treatment in this setting.

Patients and methods

Seventy-one eligible patients were included in this study. All patients received chemotherapy with gemcitabine (1,100 mg/m2 on days 1 and 8) plus oxaliplatin (130 mg/m2 on day 8) and erlotinib (100 mg p.o./day for 21 days). The treatment cycle was 21 days.

Results

Partial response was achieved in 15 patients (21 %; 95 % CI 11.63–30.62) and stable disease in 15 patients (21 %). Forty-one patients (57.8 %) experienced disease progression. Median progression-free survival was 5.2 months (range 0.6–34.7; 95 % CI 3.71–6.76). The median overall survival was 10.5 months (95 % CI 7.39–13.61) and the 1-year survival estimate 47.3 %. The main adverse events were grade 3/4 anemia occurring in three (4.2 %) patients and grade 3 and 4 thrombocytopenia occurring in eight (11.3 %) and three (4.2 %) patients, respectively. Grade 4 neutropenia was rare (1.4 %), and one patient presented febrile neutropenia.

Conclusion

This study demonstrated that the combination of gemcitabine, oxaliplatin and erlotinib is active, well tolerated and safe for patients with metastatic adenocarcinoma of the pancreas. However, the results do not seem to be better than those reported with chemotherapy alone.

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Acknowledgments

This work was partially supported by a research Grant from the Cretan Association for Biomedical Research (CABR). Dr E. K. was a recipient of a CABR clinical fellowship.

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to O. Katopodis.

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Katopodis, O., Souglakos, J., Stathopoulos, E. et al. Frontline treatment with gemcitabine, oxaliplatin and erlotinib for the treatment of advanced or metastatic pancreatic cancer: a multicenter phase II study of the Hellenic Oncology Research Group (HORG). Cancer Chemother Pharmacol 74, 333–340 (2014). https://doi.org/10.1007/s00280-014-2509-6

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  • DOI: https://doi.org/10.1007/s00280-014-2509-6

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