Sorafenib and Erlotinib in Treating Patients With Pancreatic Cancer That Cannot Be Removed by Surgery
Condition: Pancreatic Cancer
MeSH terms: Pancreatic Neoplasms
Intervention: Sorafenib; Erlotinb
Intervention description: 400 mg taken by mouth 1 time per day.; 150 mg taken by mouth 1 time per day.
Intervention MeSH terms: Sorafenib
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 37.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: recurrent pancreatic cancer; stage III pancreatic cancer; stage IV pancreatic cancer; adenocarcinoma of the pancreas

Summary:

      RATIONALE: Sorafenib and erlotinib may stop the growth of tumor cells by blocking some of the
      enzymes needed for cell growth. Sorafenib may also stop the growth of tumor cells by blocking
      blood flow to the tumor. Giving sorafenib together with erlotinib may kill more tumor cells.

      PURPOSE: This phase II trial is studying how well giving sorafenib together with erlotinib
      works in treating patients with pancreatic cancer that cannot be removed by surgery.
    

Eligibility criteria:

        DISEASE CHARACTERISTICS:

          -  Microscopically confirmed diagnosis of pancreatic adenocarcinoma

               -  Unresectable disease

               -  No neuroendocrine tumors or cystadenocarcinoma

          -  Measurable or evaluable disease by RECIST criteria

          -  No known brain metastases

               -  Patients with neurological symptoms must undergo a CT scan/MRI of the brain to
                  exclude brain metastases

        PATIENT CHARACTERISTICS:

          -  ECOG performance status 0-2

          -  ANC ≥ 1,500/mm^3

          -  Platelet count ≥ 100,000/mm^3

          -  Total bilirubin ≤ 1.5 times upper limit of normal (ULN)

          -  ALT and AST ≤ 2.5 times ULN (≤ 5 times ULN for patients with liver involvement)

          -  Creatinine ≤ 1.5 times ULN

          -  INR < 1.5 or PT/PTT normal unless patients are receiving anticoagulation treatments

          -  Negative pregnancy test

          -  Not pregnant or nursing

          -  Fertile patients must use effective barrier contraception before, during, and for at
             least 6 months after completion of study treatment

          -  Able to swallow whole pills

          -  No patients who currently smoke

          -  No cardiac disease, including any of the following:

               -  NYHA class III-IV congestive heart failure

               -  Unstable angina (anginal symptoms at rest)

               -  New-onset angina (began within the past 3 months)

               -  Myocardial infarction within the past 6 months

               -  Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy

          -  No uncontrolled hypertension defined as systolic BP > 150 mm Hg or diastolic BP > 90
             mm Hg despite optimal medical management

          -  No arterial thrombotic or embolic events (e.g., cerebrovascular accident, including
             transient ischemic attacks) within the past 6 months

          -  No pulmonary hemorrhage/bleeding event ≥ CTCAE grade 2 in the past 4 weeks

          -  No other hemorrhage/bleeding event ≥ CTCAE grade 3 in the past 4 weeks

          -  No significant traumatic injury in the past 4 weeks

          -  No known untreated malabsorption problem (e.g., ulcerative colitis, Crohn's disease)

          -  No known HIV positivity or chronic hepatitis B or C

          -  No known or suspected allergy to sorafenib tosylate or erlotinib hydrochloride

          -  No active clinically serious infection > CTCAE grade 2

          -  No serious non-healing wound, ulcer, or bone fracture

          -  No evidence or history of bleeding diathesis or coagulopathy (except for
             cancer-related blood clots)

          -  No dermatitis ≥ CTCAE grade 2 at baseline

          -  No patients who currently smoke

        PRIOR CONCURRENT THERAPY:

          -  No prior treatment with antiangiogenics (e.g., bevacizumab, thalidomide, marimastat,
             interferon alfa, vatalanib, vandetanib, ZD6126, sorafenib, semaxanib, sunitinib,
             axitinib)

          -  No more than one line of prior therapy for metastatic disease

          -  More than 4 weeks since prior major surgery or open biopsy

          -  No concurrent strong CYP34A inhibitors or inducers

          -  Concurrent warfarin or heparin allowed with the approval of the principal investigator