Erlotinib has shown activity individually, as single drugs, or in combination with chemotherapy in upper gastro-intestinal cancers, including esophageal and gastro-esophageal adenocarcinomas, gastric cancer and pancreatic cancer. Overexpression of EGFR has been reported to be observed in 10.7%, 5.1%, 12.4% and 0% of cases of intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder cancer and ampulla of Vater cancer, respectively
In a recent study, forty-two patients with biliary cancer were enrolled. Seven of the patients (17%; 95% CI, 7% to 31%) were progression free at 6 months. Three patients had partial response These results suggest a therapeutic benefit for EGFR blockade with erlotinib in patients with biliary cancer. The authors conclude that additional studies with erlotinib as a single agent and in combination with other targeted agents are warranted in this disease. Another phase II study is referenced. There are also studies in combination with bevacizumab or gemcitabine. Lubner et al enrolled fifty-three eligible patients. Of 49 evaluable patients, six (12%; 95% CI, 6% to 27%) had a confirmed partial response. Stable disease was documented in another 25 patients (51%). Median OS was 9.9 months, and TTP was 4.4 months.
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