Erbitux for gastric cancer – pro
Epidermal growth factor receptor (EGFR) is over-expressed in a significant proportion of esophageal and gastric carcinomas and there has been significant interest in targeting it. Unfortunately, it has not yet shown much progress. A phase II study by Chan et al showed minimal clinical activity of cetuximab. A recent phase III trial, EXPAND (Erbitux in Combination With Xeloda and Cisplatin in Advanced Esophagogastric Cancer), involved 904 patients in 24 countries in Asia Pacific, Europe, and Latin America, and in Japan. Patients had unresectable advanced cancer of the stomach or gastroesophageal junction, and had received no previous chemotherapy or radiotherapy. Patient outcome was similar between treatment groups and the primary and secondary endpoints were not met; progression-free survival was 4.4 versus 5.6 months and overall survival was 9.4 versus 10.7 months with cetuximab combination and control treatment, respectively. Overall response rates were 29% with cetuximab and 30% with control. Cetuximab is not listed by NCCN on p. GAST-E.
Moehler M, Galle PR, Gockel I, et al. The multidisciplinary management of gastrointestinal cancer. Multimodal treatment of gastric cancer. Best Pract Res Clin Gastroenterol. 2007;21(6):965-981.
Pinto C, Di Fabio F, Siena S, et al. Phase II study of cetuximab in combination with FOLFIRI in patients with untreated advanced gastric or gastroesophageal junction adenocarcinoma (FOLCETUX study). Ann Oncol. 2007;18(3):510-517.
J.A.Chan et al, A multicenter phase II trial of single-agent cetuximab in advanced esophageal and gastric adenocarcinoma