Erlotinib and bevacizumab have shown activity individually, as single drugs, or in combination with chemotherapy in upper gastro-intestinal cancers, including esophageal and gastro-esophageal adenocarcinomas, gastric cancer and pancreatic cancer. Biomarkers indicating an important role of EGF and VEGF have been found in these tumors, and in cholangiocarcinomas as well. There is promise that combined treatment with erlotinib and bevacizumab is active and tolerable in a broad range of upper gastro-intestinal cancers, justifying an experimental phase II-study of patients with these diagnoses, refractory or intolerant to standard systemic therapy.
Primary Objective * To determine the median time to progression (TTP) and response rate (RR) of the combination of erlotinib and bevacizumab in patients with advanced upper gastro-intestinal carcinomas, refractory or intolerant to standard systemic therapy. Secondary Objective * To determine safety, tolerability and toxicity. * To determine median and overall survival (OS). * To correlate efficacy of treatment with the expression of tumor markers obtained in serum (EFGR, bFGF, p-VEGF-A, and sVEGF-R2), in paraffin embedded tumor tissue (micro vessel density (MVD), and expression of VEGFR and EGFR, after immunostaining), and in fresh frozen tumor biopsies (micro array-based analyses of patterns of gene expression). Treatment: Bevacizumab (AvastinÒ) will be given intravenously at 10 mg/kg every other week. Erlotinib is given as an orally daily dose and most be taken at least one hour before or two hours after ingestion of food.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
126
Erlotonib 150 mg daily bevacizumab 10 mg/kg every 14 days
Århus Sygehus
Aarhus, Denmark
Rigshospitalet
Copenhagen, Denmark
Odense University Hospital
Odense, Denmark
Objective response by RECIST criteria
Time frame: From time of treatment start to response evaluation
Time to progression
Time frame: 1 year
Toxicity evaluated by NCI-CTCae version 3.0
Time frame: 1 year
Survival
Time frame: 1 year
Biomarkers
Time frame: 6 months
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