Literature DB >> 28961832

Gemcitabine combined with the monoclonal antibody nimotuzumab is an active first-line regimen in KRAS wildtype patients with locally advanced or metastatic pancreatic cancer: a multicenter, randomized phase IIb study.

B Schultheis1, D Reuter2, M P Ebert3, J Siveke3, A Kerkhoff4, W E Berdel4, R Hofheinz5, D M Behringer6, W E Schmidt7, E Goker8, S De Dosso9, M Kneba10, S Yalcin11, F Overkamp12, F Schlegel13, M Dommach14, R Rohrberg15, T Steinmetz16, M Bulitta17, D Strumberg18.   

Abstract

BACKGROUND: This randomized study was designed to investigate the superiority of gemcitabine (gem) plus nimotuzumab (nimo), an anti-epidermal growth factor receptor monoclonal antibody, compared with gem plus placebo as first-line therapy in patients with advanced pancreatic cancer. PATIENTS AND METHODS: Patients with previously untreated, unresectable, locally advanced or metastatic pancreatic cancer were randomly assigned to receive gem: 1000 mg/m2, 30-min i.v. once weekly (d1, 8, 15; q29) and nimo: fixed dose of 400 mg once weekly as a 30-min infusion, or gem plus placebo, until progression or unacceptable toxicity. The primary end point was overall survival (OS), secondary end points included time to progression, overall response rate, safety and quality of life.
RESULTS: A total of 192 patients were randomized, with 186 of them being assessable for efficacy and safety (average age 63.6 years). One-year OS/progression-free survival (PFS) was 34%/22% for gem plus nimo compared with 19%/10% for gem plus placebo (HR = 0.69; P = 0.03/HR = 0.68; P = 0.02). Median OS/PFS was 8.6/5.1 months for gem plus nimo versus 6.0/3.4 mo in the gem plus placebo group (HR = 0.69; P = 0.0341/HR = 0.68; P = 0.0163), with very few grade 3/4 toxicities. KRAS wildtype patients experienced a significantly better OS than those with KRAS mutations (11.6 versus 5.6 months, P = 0.03).
CONCLUSION: This randomized study showed that nimo in combination with gem is safe and well tolerated. The 1-year OS and PFS rates for the entire population were significantly improved. Especially, those patients with KRAS wildtype seem to benefit. The study was registered as protocol ID OSAG101-PCS07, NCT00561990 and EudraCT 2007-000338-38.
© The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Entities:  

Keywords:  EGFR inhibitor; KRAS wildtype; gemcitabine; nimotuzumab; pancreatic cancer

Mesh:

Substances:

Year:  2017        PMID: 28961832     DOI: 10.1093/annonc/mdx343

Source DB:  PubMed          Journal:  Ann Oncol        ISSN: 0923-7534            Impact factor:   32.976


  26 in total

1.  Utility of liquid biopsy using urine in patients with pancreatic ductal adenocarcinoma.

Authors:  Hiroyuki Terasawa; Hideaki Kinugasa; Soichiro Ako; Mami Hirai; Hiroshi Matsushita; Daisuke Uchida; Takeshi Tomoda; Kazuyuki Matsumoto; Shigeru Horiguchi; Hironari Kato; Kazuhiro Nouso; Hiroyuki Okada
Journal:  Cancer Biol Ther       Date:  2019-07-22       Impact factor: 4.742

Review 2.  Current and emerging therapies for patients with advanced pancreatic ductal adenocarcinoma: a bright future.

Authors:  Eric S Christenson; Elizabeth Jaffee; Nilofer S Azad
Journal:  Lancet Oncol       Date:  2020-03       Impact factor: 41.316

Review 3.  Combination Therapies and Drug Delivery Platforms in Combating Pancreatic Cancer.

Authors:  Fan Lei; Xinyuan Xi; Surinder K Batra; Tatiana K Bronich
Journal:  J Pharmacol Exp Ther       Date:  2019-02-22       Impact factor: 4.030

Review 4.  Pancreatic Adenocarcinoma: Unconventional Approaches for an Unconventional Disease.

Authors:  Christopher Gromisch; Motaz Qadan; Mariana Albuquerque Machado; Kebin Liu; Yolonda Colson; Mark W Grinstaff
Journal:  Cancer Res       Date:  2020-03-27       Impact factor: 12.701

Review 5.  New Treatment Strategies for Metastatic Pancreatic Ductal Adenocarcinoma.

Authors:  Ritu Raj Singh; Eileen M O'Reilly
Journal:  Drugs       Date:  2020-05       Impact factor: 9.546

6.  A KRAS wild type mutational status confers a survival advantage in pancreatic ductal adenocarcinoma.

Authors:  Annika L Windon; Arturo Loaiza-Bonilla; Christopher E Jensen; Michael Randall; Jennifer J D Morrissette; Stuti G Shroff
Journal:  J Gastrointest Oncol       Date:  2018-02

7.  Pancreatic ductal adenocarcinoma in the era of precision medicine.

Authors:  Binbin Zheng-Lin; Eileen M O'Reilly
Journal:  Semin Oncol       Date:  2021-02-11       Impact factor: 4.929

Review 8.  Mutations in key driver genes of pancreatic cancer: molecularly targeted therapies and other clinical implications.

Authors:  Hai-Feng Hu; Zeng Ye; Yi Qin; Xiao-Wu Xu; Xian-Jun Yu; Qi-Feng Zhuo; Shun-Rong Ji
Journal:  Acta Pharmacol Sin       Date:  2021-02-11       Impact factor: 7.169

Review 9.  Impact of posttranslational modifications in pancreatic carcinogenesis and treatments.

Authors:  Nianhong Chen; Qiaoqiao Zheng; Guoqing Wan; Feng Guo; Xiaobin Zeng; Ping Shi
Journal:  Cancer Metastasis Rev       Date:  2021-08-03       Impact factor: 9.264

Review 10.  Reviewing the Utility of EUS FNA to Advance Precision Medicine in Pancreatic Cancer.

Authors:  William Berry; Joanne Lundy; Daniel Croagh; Brendan J Jenkins
Journal:  Cancers (Basel)       Date:  2018-01-27       Impact factor: 6.639

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