S0941: a phase 2 SWOG study of sorafenib and erlotinib in patients with advanced gallbladder carcinoma or cholangiocarcinoma Journal Article

Authors: El-Khoueiry, A. B.; Rankin, C.; Siegel, A. B.; Iqbal, S; Gong, I. Y.; Micetich, K. C.; Kayaleh, O. R.; Lenz, H. J.; Blanke, C. D.
Article Title: S0941: a phase 2 SWOG study of sorafenib and erlotinib in patients with advanced gallbladder carcinoma or cholangiocarcinoma
Abstract: BACKGROUND: Gallbladder cancers and cholangiocarcinomas make up a heterogenous group of tumours with a poor prognosis in advanced stages. On the basis of evidence of dysregulation of the epidermal growth factor receptor, vascular endothelial growth factor and mitogen-activated protein kinase pathways in biliary cancers, we performed a phase 2 trial of sorafenib and erlotinib in patients with advanced biliary cancers. METHODS: Eligible patients were previously untreated in the advanced setting with adequate hepatic and bone marrow function. Sorafenib and erlotinib were administered continuously at 400 mg BID and 100 mg daily, respectively. RESULTS: Thirty-four eligible patients were recruited. The study was terminated after the first stage of accrual owing to failure to meet the predetermined number of patients who were alive and progression free at 4 months. There were two unconfirmed partial responses (6%, 95% CI: 1-20%), with a median progression-free survival of 2 months (95% CI: 2-3), and median overall survival of 6 months (95% CI: 3-8 months). Grade 3 and 4 adverse events included hypertension, AST/ALT increase, bilirubin increase, diarrhoea, hypokalaemia, hypophosphatemia and rash. CONCLUSIONS: Despite compelling preclinical rationale, the combination of sorafenib and erlotinib does not have promising clinical activity in an unselected population of patients with biliary cancers. Improved patient selection based on tumour biology and molecular markers is critical for future evaluation of targeted therapies in this disease.
Journal Title: British journal of cancer
Volume: 110
Issue: 4
ISSN: 1532-1827; 0007-0920
Publisher: Unknown  
Journal Place: England
Date Published: 2014
Start Page: 882
End Page: 887
Language: eng
Notes: LR: 20150218; GR: CA13612/CA/NCI NIH HHS/United States; GR: CA16385/CA/NCI NIH HHS/United States; GR: CA20319/CA/NCI NIH HHS/United States; GR: CA32102/CA/NCI NIH HHS/United States; GR: CA35090/CA/NCI NIH HHS/United States; GR: CA35176/CA/NCI NIH HHS/United States; GR: CA35431/CA/NCI NIH HHS/United States; GR: CA37981/CA/NCI NIH HHS/United States; GR: CA38926/CA/NCI NIH HHS/United States; GR: CA45807/CA/NCI NIH HHS/United States; GR: CA46282/CA/NCI NIH HHS/United States; GR: CA46441/CA/NCI NIH HHS/United States; GR: CA58723/CA/NCI NIH HHS/United States; GR: CA58882/CA/NCI NIH HHS/United States; GR: CA63844/CA/NCI NIH HHS/United States; GR: CA63848/CA/NCI NIH HHS/United States; GR: CA67575/CA/NCI NIH HHS/United States; GR: K23 CA149084/CA/NCI NIH HHS/United States; JID: 0370635; 0 (Phenylurea Compounds); 0 (Protein Kinase Inhibitors); 0 (Quinazolines); 0 (VEGFA protein, human); 0 (Vascular Endothelial Growth Factor A); 25X51I8RD4 (Niacinamide); 9ZOQ3TZI87 (sorafenib); EC (Receptor, Epidermal Growth Factor); J4T82NDH7E (erlotinib); OID: NLM: PMC3929880; 2013/07/23 [received]; 2013/11/04 [revised]; 2013/12/02 [accepted]; 2014/01/14 [aheadofprint]; ppublish