Herceptin and gemcitabine for metastatic pancreatic cancers that overexpress HER-2/neu

Howard Safran, David Iannitti, Ramesh Ramanathan, Jonathan D. Schwartz, Margaret Steinhoff, Chris Nauman, Paul Hesketh, Ritesh Rathore, Robert Wolf, Umadevi Tantravahi, Marilyn Hughes, Chris Maia, Terry Pasquariello, Lisa Goldstein, Thomas King, James Y. Tsai, Teresa Kennedy

Research output: Contribution to journalArticle

140 Scopus citations

Abstract

Purpose: To determine the response rate and toxicities of Herceptin and gemcitabine for patients with metastatic pancreatic adenocarcinomas that overexpress HER-2/neu. Methods and Materials: Patients with metastatic pancreatic cancer with 2+/3+ HER-2/neu expression by immunohistochemistry were eligible. Patients received gemcitabine, 1 g/m2/week, for 7 of 8 weeks followed by 3 of every 4 weeks, and Herceptin, 4 mg/kg loading dose, followed by 2 mg/kg/week. Results: Screening logs demonstrated the rate of HER-2/neu overexpression was 16%. Thirty-four patients were enrolled. Thirty patients (88%) had pancreatic cancers with 2+ overexpression and 4 patients (12%) had 3+ overexpression. Toxicity was similar to gemcitabine alone. Confirmed partial responses were observed in 2 of 32 patients (6%). Thirteen of 32 patients (41%) had either a partial response or a > 50% reduction in CA 19-9. The median survival for all 34 patients was 7 months, and the 1-year survival was 19%. Conclusion: The response rate of Herceptin and gemcitabine is similar to gemcitabine alone. The 7-month median survival in patients with metastatic pancreatic cancer suggests there may be a modest benefit for some patients. Infrequent HER-2/neu overexpression limits the role of targeting the HER-2/neu gene and prevents definitive conclusions on the addition of Herceptin to gemcibine for patients with pancreatic cancer.

Original languageEnglish (US)
Pages (from-to)706-712
Number of pages7
JournalCancer Investigation
Volume22
Issue number5
DOIs
StatePublished - Dec 1 2004

Keywords

  • HER-2/neu
  • Herceptin
  • Pancreatic adenocarcinoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Safran, H., Iannitti, D., Ramanathan, R., Schwartz, J. D., Steinhoff, M., Nauman, C., Hesketh, P., Rathore, R., Wolf, R., Tantravahi, U., Hughes, M., Maia, C., Pasquariello, T., Goldstein, L., King, T., Tsai, J. Y., & Kennedy, T. (2004). Herceptin and gemcitabine for metastatic pancreatic cancers that overexpress HER-2/neu. Cancer Investigation, 22(5), 706-712. https://doi.org/10.1081/CNV-200032974