Table 1.
Trials of EGFR inhibitors in advanced gastric/esophagogastric cancer.
| Combination of EGFR and other pathway inhibitors | ||||||
|---|---|---|---|---|---|---|
| Drugs | Target | Evaluation of EGFR status | Status (Phase of trial) | Type of cancer | Results | References |
| Matuzumab plus epirubicin, cisplatin, and capecitabine (ECX) | EGFR | Enrolled patients with EGFR positive by IHC | Phase II | Advanced esophagogastric adenocarcinoma | ORR: 31% for ECX/matuzumab vs. 58% for the ECX-alone (P = 0.994) | (18) |
| Panitumumab plus epirubicin, oxaliplatin, and capecitabine (EOC; REAL3 trial) | EGFR | Not tested | Phase III | Advanced esophagogastric adenocarcinoma | Median OS for EOC was 11.3 vs. 8.8 months with mEOC + P (HR = 1.37, 95% CI = 1.07–1.76; p = 0.013) | (19) |
| Cetuximab plus capecitabine and cisplatin (EXPAND trial) | EGFR | Not tested | Phase III | Advanced esophagogastric adenocarcinoma | Median PFS for capecitabine-cisplatin plus cetuximab was 4.4 vs. 5.6 months for capecitabine-cisplatin alone (HR = 1.09, 95% CI = 0.92–1.29; p = 0.32) | (20) |
| Cetuximab (C) plus docetaxel + oxaliplatin (DOCOX) | EGFR | Not tested | Phase II | Advanced esophagogastric adenocarcinoma | Median PFS was 4.7 months for DOCOX (CI = 3.0–5.6) vs. 5.1 months for C + DOCOX (CI = 4.3–5.9) | (21) |
| Median OS was 8.5 vs. 9.4 month, 1-year OS rate was 39.1 and 33.0%, ORR was 26 and 38%, respectively, for DOCOX and C + DOCOX | ||||||
| Panitumumab plus docetaxel, cisplatin, and fluoropyrimidine (ATTAX3 trial) | EGFR | Not tested | Phase II | Advanced esophagogastric adenocarcinoma | RR was 49% in the docetaxel, cisplatin, and fluoropyrimidine arm (CI = 34–64%) and 58% in the Panitumumab plus docetaxel, cisplatin, and fluoropyrimidine arm (CI = 42–72%) | (22) |
| Median overall survival was 11.7 months in the chemotherapy arm and 10 months in the combination arm | ||||||
| Nimotuzumab plus cisplatin and S-1 (NCS) | EGFR | Not tested | Phase II | Advanced esophagogastric adenocarcinoma | ORR for NCS was 54.8 vs. 58.1% for CS alone (P = 0.798) | (23) |
| Median PFS for CS arm vs. NCS arm (7.2 vs. 4.8 months HR = 2.136; 95% CI = 1.193–3.826; P = 0.011) | ||||||
| OS for patients in CS arm vs. NCS arm (14.3 vs. 10.2 months; HR = 1.776; 95% CI = 0.972–3.246; P = 0.062) | ||||||
| FOLFOX6 + erlotinib (single-arm study) | EGFR | Not tested for enrollment | Phase II | Advanced esophagus and gastroesophageal junction adenocarcinoma | ORR 45% | (24) |
| Median PFS 5.5 months (95% CI = 3.1–7.5 months) | ||||||
| Median OS 11 months (95% CI = 8.0–17.4 months) | ||||||
CI, confidence interval; HR, hazard ratio; OS, overall survival; PFS, progression-free survival; PR, partial response; RR, response rate; WT, wild type; ORR, objective response rate.