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01.04.2011 | Original Article

A phase I study evaluating the role of the anti-epidermal growth factor receptor (EGFR) antibody cetuximab as a radiosensitizer with chemoradiation for locally advanced pancreatic cancer

verfasst von: J. P. Arnoletti, A. Frolov, M. Eloubeidi, K. Keene, J. Posey, T. Wood, Edward Greeno, N. Jhala, S. Varadarajulu, S. Russo, J. Christein, R. Oster, D. J. Buchsbaum, S. M. Vickers

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 4/2011

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Abstract

Purpose

(1) To determine the safety of the epidermal growth factor receptor (EGFR) antibody cetuximab with concurrent gemcitabine and abdominal radiation in the treatment of patients with locally advanced adenocarcinoma of the pancreas. (2) To evaluate the feasibility of pancreatic cancer cell epithelial–mesenchymal transition (EMT) molecular profiling as a potential predictor of response to anti-EGFR treatment.

Methods

Patients with non-metastatic, locally advanced pancreatic cancer were treated in this dose escalation study with gemcitabine (0–300 mg/m²/week) given concurrently with cetuximab (400 mg/m² loading dose, 250 mg/m² weekly maintenance dose) and abdominal irradiation (50.4 Gy). Expression of E-cadherin and vimentin was assessed by immunohistochemistry in diagnostic endoscopic ultrasound fine-needle aspiration (EUS-FNA) specimens.

Results

Sixteen patients were enrolled in 4 treatment cohorts with escalating doses of gemcitabine. Incidence of grade 1–2 adverse events was 96%, and incidence of 3–4 adverse events was 9%. There were no treatment-related mortalities. Two patients who exhibited favorable treatment response underwent surgical exploration and were intraoperatively confirmed to have unresectable tumors. Median overall survival was 10.5 months. Pancreatic cancer cell expression of E-cadherin and vimentin was successfully determined in EUS-FNA specimens from 4 patients.

Conclusions

Cetuximab can be safely administered with abdominal radiation and concurrent gemcitabine (up to 300 mg/m²/week) in patients with locally advanced adenocarcinoma of the pancreas. This combined therapy modality exhibited limited activity. Diagnostic EUS-FNA specimens could be analyzed for molecular markers of EMT in a minority of patients with pancreatic cancer.

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Titel: A phase I study evaluating the role of the anti-epidermal growth factor receptor (EGFR) antibody cetuximab as a radiosensitizer with chemoradiation for locally advanced pancreatic cancer
verfasst von: J. P. Arnoletti
A. Frolov
M. Eloubeidi
K. Keene
J. Posey
T. Wood
Edward Greeno
N. Jhala
S. Varadarajulu
S. Russo
J. Christein
R. Oster
D. J. Buchsbaum
S. M. Vickers
Publikationsdatum: 01.04.2011
Verlag: Springer-Verlag
Erschienen in: Cancer Chemotherapy and Pharmacology / Ausgabe 4/2011
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-010-1383-0

Springer Medizin

A phase I study evaluating the role of the anti-epidermal growth factor receptor (EGFR) antibody cetuximab as a radiosensitizer with chemoradiation for locally advanced pancreatic cancer