Table 4.

Outcomes of ErbB-targeted therapies in patients with advanced biliary cancer

Assessable patients	Tumor	ErbB status	ErbB inhibitor	Target	Administration	Response	Ref.
40	Unresected or metastatic biliary tract cancers (gallbladder, intra- and extrahepatic bile duct)	29/36 (81%) assessable tumor samples positive for EGFR expression	Erlotinib	EGFR	Single agent	PR-3 patients; SD-17 patients; median time to disease-progression of 2.6 mo	[185]
1	Metastatic cholangiocarcinoma	Negative EGFR expression in tumor	Cetuximab	EGFR	In combination with 5'flurouracil, folic acid, and radiotherapy	PR in intra-chemotherapeutic state	[186]
1	Unresected cholangiocarcinoma with peritoneal carcinomatosis	Positive EGFR expression in tumor	Cetuximab	EGFR	In combination with gemcitabine	PR with 30% reduction in hepatic mass and disappearance of peritoneal carcinomatosis as shown by computed tomography	[187]
9	Unresected cholangiocarcinoma with disease progression after at least 3 cycles of gemcitabine-oxaliplatin	9/9 (100%) tumor samples positive for EGFR expression, with all being negative for membranous ErbB2	Cetuximab	EGFR	In combination with gemcitabine-oxaliplatin	After 6 mo, CR-1 patient; PR-1 patient; SD-1 patient; progressive disease-6 patients; all patients relapsed, with a median time to disease progression of 4 mo	[188]
17	Unresected advanced biliary tract cancers (gallbladder, bile duct)	Not reported	Lapatinib	EGFR/ErbB2	Single agent	No observed responses; 5 patients with SD; cohort closed due to no noted lapatinib activity	[189]
6 with biliary tract cancers out of a total of 34 with various types of solid tumors	Advanced cholangiocarcinoma (5) or gallbladder cancer (1)	Not investigated	Lapatinib	EGFR/ErbB2	In combination with oxaliplatin/5-flurouracil/leucovorin	PR-1 patient with cholangiocarcinoma and 1 patient with gallbladder cancer	[190]

CR: Complete response; PR: Partial response; SD: Stable disease.