New results published by the Journal of Clinical Oncology show that adding Tarceva (erlotinib) to gemcitabine chemotherapy significantly improves survival by 22 percent in patients with advanced pancreatic cancer.
This survival increase is impressive as pancreatic cancer is a particularly fatal form of cancer responsible for over 80,000 deaths across Europe each year. Despite significant advances in the treatment of many other tumours, treatment options for pancreatic patients are extremely limited and until now, no therapies have demonstrated an improvement in survival for the past decade.
"This study is important because it shows the benefit of a new approach to treat this deadly disease," said Dr. Malcolm Moore, Study Chair and Chief of Medical Oncology and Hematology at Princess Margaret Hospital, University of Toronto. "This is the first study in ten years to demonstrate an improvement in survival in pancreatic cancer, and as a physician I'm delighted to have additional treatment options for my patients."
Data from this study, conducted by the National Cancer Institute of Canada (NCIC), formed the basis of the recent European approval of Tarceva for the treatment of patients with metastatic pancreatic cancer (in combination with chemotherapy) announced in January this year.
The results showed a statistically significant increase in overall survival in patients with advanced pancreatic cancer who received Tarceva plus gemcitabine, compared to patients receiving gemcitabine alone with an overall 22 percent improvement in survival (p=0.038). A higher percentage of patients were alive at 12 months in the group treated with Tarceva plus gemcitabine, compared to those treated with chemotherapy alone (23% v 17%; p=0.023). Progression-free survival was also significantly improved for patients treated with Tarceva (p=0.004).
Pancreatic cancer is the sixth most frequently occurring cancer in Europe. In 2002, there were more than 78,000 new cases of pancreatic cancer diagnosed in Europe, with a death rate of approximately 82,000 people per year. Pancreatic cancer is difficult to treat as it is often resistant to chemotherapy and radiotherapy, and tends to spread quickly to other parts of the body, leading to its high mortality and short life expectancy. Most people diagnosed with pancreatic cancer have less than one year to live. This is the second cancer type in which Tarceva has demonstrated a clear survival benefit and it makes Tarceva the first and only EGFR(x) targeted treatment to have shown a significant survival benefit in patients with pancreatic cancer, when added to gemcitabine, and in patients with non-small cell lung cancer (NSCLC).
The multi-centre, randomised, double-blind, placebo-controlled Phase III international study was conducted by the National Cancer Institute of Canada, Clinical Trials Group at Queen's University (NCIC CTG) in cooperation with AGITG and investigators in 15 other countries and co-sponsored by OSI Pharmaceuticals. The study evaluated Tarceva at 100mg/day or 150mg/day in patients with locally advanced or metastatic pancreatic cancer. Patients received either gemcitabine with Tarceva or gemcitabine plus placebo. A total of 569 patients were randomised into the study, with 285 patients receiving Tarceva plus gemcitabine and 284 patients receiving placebo plus gemcitabine. Treatment was generally well tolerated in both arms. Most adverse events associated with Tarceva plus gemcitabine in this study were mild-to-moderate, and consistent with those observed in previous clinical trials including rash and diarrhoea.
Tarceva has been approved by the FDA since November 2005 for treatment of locally advanced, unresectable or metastatic pancreatic cancer in combination with gemcitabine chemotherapy, and has been approved for treatment of metastatic pancreatic cancer in the European Union since January 2007.
Tarceva has been approved in the European Union since September 2005 and in the US since November 2004 for the treatment of patients with locally advanced or metastatic NSCLC after failure of at least one prior chemotherapy regimen. Early-stage trials of Tarceva are also being conducted in several other solid tumours as part of the ongoing research programme.