Erlotinib: success of a molecularly targeted agent for the treatment of advanced pancreatic cancer.

Epidermal growth factor receptor (EGFR) is overexpressed by several solid tumors, including pancreatic cancer, and has become an important target for novel anticancer pharmacotherapy. Erlotinib (Tarceva, OSI-774) is an orally available small-molecule inhibitor of the EGFR tyrosine kinase. The addition of erlotinib to gemcitabine has been shown to prolong survival of patients treated for advanced pancreatic cancer in the National Cancer Institute of Canada PA.3 trial. This survival advantage is small yet noteworthy, in that numerous gemcitabine-containing combinations have failed to show a statistically significant survival advantage over gemcitabine alone. The most frequent toxicities associated with the addition of erlotinib are diarrhea and rash. Erlotinib-induced rash appears to be predictive of outcome. Further clinical studies of erlotinib in the treatment of pancreatic cancer are ongoing.