title: A phase 2 trial of erlotinib in patients with previously treated squamous cell and adenocarcinoma of the esophagus.
abstract: BACKGROUND
  Tyrosine kinase inhibitors (TKIs) of the epidermal growth factor receptor (EGFR) have activity in solid tumors. The authors evaluated an oral EGFR TKI, erlotinib, in patients with previously treated esophageal cancer.
  
  
  METHODS
  Thirty patients with measurable, metastatic cancer of the esophageal and gastroesophageal junction received 150 mg erlotinib daily. EGFR-negative tumors (6 patients; 20%) and EGFR-over expressing tumors (24 patients; 80%) were treated. Most patients were men (70%) with adenocarcinoma (57%) and had received previous chemotherapy (97%).
  
  
  RESULTS
  Two partial responses were observe d in the EGFR-positive cohort (2 of 24 patients; 8%), and no responses were observed in the EGFR-negative cohort (0 of 6 patients). Reponses were limited to patients who had squamous cell carcinoma (2 of 13 patients; 15%; response duration, 5.5-7 months). The time to tumor progression was longer in patients who had squamous cell carcinoma (3.3 months; range, 1-24 months) compared with patients who had adenocarcinoma (1.6 months; range, 1-6 months; P = .026). Therapy was tolerable with the expected toxicity of skin rash (grade 1-2, 67%; grade 3, 10%).
  
  
  CONCLUSIONS
  Erlotinib had limited activity in patients with esophageal cancer, and responses and some protracted stable disease were observed in those with squamous cell carcinoma. Efficacy according to EGFR status could not be assessed given the rarity of EGFR-negative tumors. The current results indicated that further evaluation of this agent in squamous cell carcinoma is warranted. Cancer 2011. © 2010 American Cancer Society.
authors.affiliation: Gastrointestinal Oncology Service/Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. ilsond@mskcc.org
authors.forename: David H
authors.initials: DH
authors.lastname: Ilson
authors.forename: David
authors.initials: D
authors.lastname: Kelsen
authors.forename: Manish
authors.initials: M
authors.lastname: Shah
authors.forename: Gary
authors.initials: G
authors.lastname: Schwartz
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Levine
authors.forename: Jeff
authors.initials: J
authors.lastname: Boyd
authors.forename: Marinela
authors.initials: M
authors.lastname: Capanu
authors.forename: Benjamin
authors.initials: B
authors.lastname: Miron
authors.forename: David
authors.initials: D
authors.lastname: Klimstra
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors* / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011799:Quinazolines / Q000627:therapeutic use*; D019233:Retreatment
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors