This is the first trial to show a targeted agent with a survival benefit in pancreatic cancer
Overall survival and progression free survival were both improved
There is increased but tolerable toxicity associated with erlotinib
The presence of a skin rash due to therapy denoted a better prognosis
This study is important because it shows, for the first time, an effect of targeted therapy in pancreatic cancer. Its improvements, however, are underwhelming. The overall survival increase was 15 days and the progression free survival was 6 days. Given that it was powered to detect a 33% increase in survival, it is puzzling how it is so statistically significant. It was mentioned in the presentation that the curves continued to separate, which is encouraging, but still not a great cause for optimism. Given the costs and increased toxicity, it is uncertain at best as to whether this treatment should be accepted as a new standard of care. It is interesting that patients with increased skin toxicity had the best responses and is further proof that more careful patient selection and better understanding of the biology of the disease is needed.
Apr 9, 2010 - In patients with advanced biliary tract cancer, cisplatin plus gemcitabine is linked to a survival advantage compared to gemcitabine alone, with no additional substantial toxicity, according to research published in the April 8 issue of the New England Journal of Medicine.