Lopinavir data on the effect of panitumumab in biliary tract cancer, but in a few studies, cetuximab has been evaluated. In the trial by Gruenberger et al. 30 patients received gemcitabine, oxaliplatin, and cetuximab. They found a remarkably high RR of 63% and median PFS and OS were 8.8 and 15.2 months, respectively. Preliminary results from a randomized phase II trial with gemcitabine and oxaliplatin with or without cetuximab showed a more modest 11% RR in the first 18 patients treated with the triplet. PFS was 7 months in the cetuximab arm and 5 months in the chemotherapy-only arm. This is the first marker-driven phase II trial in irresectable biliary tract cancer. Three in four patients were alive without progression at 6 months and the median OS was 10.0 months.
Toxicity related to chemotherapy was acceptable and the most frequent side-effect to Paeonol panitumumab was skin rash. The marker-driven approach and the treatment combining chemotherapy with panitumumab in patients with KRAS wildtype tumors was feasible and met the efficacy criteria for future testing in a randomized trial. Pancreatic cancer has a very poor prognosis, making it one of the five most common causes of cancer mortality in developed countries. After curative intended resection only 5–10% of patients with adenocarcinoma of the pancreas will be alive at 5 years after diagnosis. Advanced pancreatic cancer is an incurable disease with limited treatment options. Since more than a decade, the nucleoside analogue gemcitabine is regarded as a standard of care for patients with advanced disease, providing clinical benefit and a moderate improvement in survival. Several randomised phase III trials failed to show a survival benefit for gemcitabine-based combination chemotherapy so far; however, meta-analytic data suggest a possible survival benefit for the use of fluoropyrimidines including purchase Docetaxel capecitabine in combination with gemcitabine in selected patients, that is, those with metastatic disease and a good performance status.
The anti-EGFR tyrosine kinase inhibitor erlotinib was demonstrated to result in superior survival, especially in patients developing skin rash. HER2 is a related receptor tyrosine kinase encoded by proto-oncogenes. Once activated, the signaltransduction cascade promotes cellular proliferation migration and survival. Immunohistochemical (IHC) overexpression of HER2 in various tumour cells has been not only associated with a poor prognosis, but also offers the therapeutic option of receptor targeting therapies. Studies order Docetaxel report HER2 expression in up to 45% of patients with pancreatic cancer. Targeting HER2 in pancreatic cancer cell lines and a xenograft mouse model showed encouraging results.Therefore, the aim of this study was to clarify the clinical significance of HER2 expression in patients with metastatic pancreatic cancer and to determine the potential of HER2 as therapeutic target in these patients.
On the basis of these data, we assessed the activity of the combination of trastuzumab basal lamina and capecitabine in patients with advanced IHC t3 HER2 expressing pancreatic cancer or HER2 gene amplification. As the outcome of patients with locally advanced and metastatic pancreatic cancer is different and the response assessment in the latter is more reliable.