title: Phase II study of erlotinib in patients with advanced biliary cancer.
abstract: OBJECTIVE
  Epidermal growth factor receptor/human epidermal growth factor receptor 1 and ligand expression is common in biliary cancers (BILI) and may be associated with worse outcome. The primary objective of this study was to determine the proportion of patients with advanced BILI who were progression-free at 6 months.
  
  
  METHODS
  Patients with either unresectable or metastatic disease were studied. Only one prior systemic or locoregional therapy was allowed. Erlotinib was administered continuously at a dose of 150 mg per day orally.
  
  
  RESULTS
  Forty-two patients with BILI were enrolled. The median age was 67 years (range, 33 to 82 years). Fifty-two percent of patients had Eastern Cooperative Oncology Group performance status of 1. Fifty-seven percent of patients had received prior chemotherapy for advanced BILI. HER1/EGFR expression by immunohistochemistry in tumor cells was detected in 29 (81%) of the 36 assessable patients. Seven of the patients (17%; 95% CI, 7% to 31%) were progression free at 6 months. Three patients had partial response by Response Evaluation Criteria in Solid Tumors Group classification of duration 4, 4, and 14 months, respectively. All responding patients had mild (grade 1/2) skin rash and two patients had positive tumoral HER1/EGFR expression. Three patients (7%) had toxicity-related dose reductions of erlotinib due to grade 2/3 skin rash.
  
  
  CONCLUSIONS
  Results suggest a therapeutic benefit for EGFR blockade with erlotinib in patients with biliary cancer. Additional studies with erlotinib as a single agent and in combination with other targeted agents are warranted in this disease.
authors.affiliation: Karmanos Cancer Institute, Wayne State University, 4-HWCRC, 4100 John R St, Detroit, MI 48201, USA. philipp@karmanos.org
authors.forename: Philip A
authors.initials: PA
authors.lastname: Philip
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Mahoney
authors.forename: Cristine
authors.initials: C
authors.lastname: Allmer
authors.forename: James
authors.initials: J
authors.lastname: Thomas
authors.forename: Henry C
authors.initials: HC
authors.lastname: Pitot
authors.forename: George
authors.initials: G
authors.lastname: Kim
authors.forename: Ross C
authors.initials: RC
authors.lastname: Donehower
authors.forename: Tom
authors.initials: T
authors.lastname: Fitch
authors.forename: Joel
authors.initials: J
authors.lastname: Picus
authors.forename: Charles
authors.initials: C
authors.lastname: Erlichman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000188:drug therapy*; D018450:Disease Progression; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors