Phase II Trial of Bevacizumab and Erlotinib in Carcinomas of Unknown Primary Site: The Minnie Pearl Cancer Research Network

Hainsworth, John D.; Spigel, David R.; Farley, C.; Thompson, Dana S.; Shipley, Dianna; Greco, F. Anthony

doi:10.1200/jco.2006.09.3047

Cited by 104 publications

(44 citation statements)

References 20 publications

(4 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent data have shown that for EGFR inhibitors -at least in colorectal and lung cancer -the mutational status of k-ras is a strong predictor of response efficacy (Linardou et al, 2008) which may apply to CUP, too. A recent pilot study combining bevacizumab and erlotinib in heterogeneous patients has shown considerable efficacy in CUP with a median overall survival of 7.4 months and 33% of patients alive at 1 year (Hainsworth et al, 2007). A high level of EGFR expression of 66% was observed in another study, with EGFR-expressing patients responding considerably better to platinum-based therapy (Massard et al, 2007).…”

Section: Discussionmentioning

confidence: 89%

Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial

et al. 2008

View full text Add to dashboard Cite

Platinum/taxane combinations are widely used in patients with carcinoma of unknown primary (CUP), yielding response rates of 30% and median overall survival of 9 -11 months in selected patients. Yet these combinations have not been subject to a randomised trial to overcome selection bias, a major problem in CUP. We randomised 92 patients to either paclitaxel/carboplatin (arm A) or the non-platinum non-taxane regimen gemcitabine/vinorelbine (arm B). The primary endpoint was rate of practicability as defined: application of X2 cycles of therapy (1) with a maximal delay of 1 week (2) and survival of X8 months (3). Practicability was shown in 52.4% (95% CI 36 -68%) in arm A and in 42.2% (95% CI 28 -58%) in arm B, respectively. The median overall survival, 1-year survival -rate and response rate of patients treated in arm A was 11.0 months, 38, and 23.8%, arm B 7.0 months, 29, and 20%. In conclusion, the paclitaxel/carboplatin regimen showed clinically meaningful activity in this randomised trial (Clinical trial registration number 219, 'Deutsches KrebsStudienRegister', German Cancer Society.)

show abstract

Section: Discussionmentioning

confidence: 89%

Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial

et al. 2008

View full text Add to dashboard Cite

show abstract

“…In addition, VEGF blockade appears to prevent the development of resistance to EGFR inhibition [24]. Clinically, the combination of bevacizumab and erlotinib is well tolerated and it has shown activity in several malignancies [9,25,26]. We chose to incorporate agents inhibiting both the VEGF and EGFR pathways based on our previous demonstration of the activity of the bevacizumab-erlotinib combination in the second-line treatment of CUP patients [9].…”

Section: Discussionmentioning

confidence: 99%

“…Because three of these four primary sites are among the most commonly identified at autopsy in patients with CUP [8], it seems likely that these targets are also pertinent in the empiric treatment of patients with CUP. In a previous trial, we investigated the combination of bevacizumab with erlotinib, primarily as a second-line treatment [9]. This combination had substantial activity: 71% of patients were progression free at first re-evaluation, and the median survival duration for this group of previously treated patients was 7.4 months.…”

Section: Introductionmentioning

confidence: 99%

Paclitaxel/Carboplatin plus Bevacizumab/Erlotinib in the First-Line Treatment of Patients with Carcinoma of Unknown Primary Site

et al. 2009

Self Cite

View full text Add to dashboard Cite

Introduction. This phase II trial evaluated the efficacy and toxicity of the combination of paclitaxel, carboplatin, bevacizumab, and erlotinib in the first-line treatment of patients with carcinoma of unknown primary site (CUP).Methods. Patients with previously untreated CUP (adenocarcinoma, poorly differentiated carcinoma, poorly differentiated squamous carcinoma) without clinical or pathologic characteristics of a well-defined treatable subset were eligible. All patients received paclitaxel, carboplatin, bevacizumab, and erlotinib. Treatment cycles were repeated at 21-day intervals. After four cycles, paclitaxel and carboplatin were discontinued; bevacizumab-erlotinib treatment was continued until tumor progression. Patients were initially evaluated for response after completion of two treatment cycles; re-evaluations occurred every 6 weeks thereafter.

show abstract

“…6,7 The combination of bevacizumab and erlotinib has also been studied in the second-line setting. 18 Although the major response rate with this combination was also low (10%), this regimen appeared to have better activity in producing a median PFS of 4 months and a median overall survival Figure 1. Progression-free survival is shown.…”

Section: Discussionmentioning

confidence: 97%

Oxaliplatin and capecitabine in the treatment of patients with recurrent or refractory carcinoma of unknown primary site

Hainsworth

Spigel

Burris

et al. 2010

Cancer

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Despite the widespread use of oxaliplatin-based regimens for colorectal and other gastrointestinal cancers, there is surprisingly little information regarding their empiric use for the treatment of carcinoma of unknown primary site (CUP). In the current study, the combination of oxaliplatin and capecitabine in patients with recurrent and refractory CUP was examined. METHODS: Patients with CUP who had received at least 1 previous chemotherapy regimen were treated with oxaliplatin (130 mg/m 2 intravenously on Day 1) and capecitabine (1000 mg/m 2 orally twice daily on Days 1-14). Treatment cycles were repeated every 21 days. Patients with objective response or stable disease after 2 cycles continued treatment for 6 cycles or until disease progression. RESULTS: Nine of 48 patients (19%) had objective responses to treatment; an additional 22 patients had stable disease at the time of first re-evaluation. After a median follow-up of 17 months, the median progression-free and overall survivals were 3.7 months and 9.7 months, respectively. This regimen was reasonably well tolerated by most patients. CONCLUSIONS: The combination of oxaliplatin and capecitabine was found to have activity as a salvage treatment for patients with CUP. This regimen should be considered in patients with clinical and pathologic features suggesting a primary site in the gastrointestinal tract. Further development of the regimen as a first-line therapy, or with bevacizumab added, is indicated. Cancer 2010;116:2448-54.

show abstract

Phase II Trial of Bevacizumab and Erlotinib in Carcinomas of Unknown Primary Site: The Minnie Pearl Cancer Research Network

Cited by 104 publications

References 20 publications

Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial

Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial

Paclitaxel/Carboplatin plus Bevacizumab/Erlotinib in the First-Line Treatment of Patients with Carcinoma of Unknown Primary Site

Oxaliplatin and capecitabine in the treatment of patients with recurrent or refractory carcinoma of unknown primary site

Contact Info

Product

Resources

About