Merck KGaA, Darmstadt, Germany
Merck KGaA, Darmstadt, Germany

Merck KGaA: EXPAND Study Investigating Erbitux as 1st Line Treatment in Advanced Gastric Cancer Completes Recruitment

  • International Phase III trial investigates potential role of Erbitux in gastric cancer in combination with chemotherapy
  • Encouraging activity previously demonstrated in three Phase II studies(1,2,3)

Darmstadt, Germany, January 5, 2011 - Merck KGaA announced today that recruitment has been completed for the pivotal Phase III EXPAND(a) clinical trial investigating the efficacy of Erbitux® (cetuximab) in treating patients with advanced gastric cancer. The international study has recruited more than 870 patients since commencing enrollment in 2008.

“Erbitux has shown promising efficacy in several Phase II studies so there is strong rationale for larger scale investigation of the drug’s efficacy in this disease,” explained lead investigator Dr. Florian Lordick, MD, Klinikum Braunschweig, Hannover Medical School, Germany. “Gastric cancer is known to be difficult to treat, therefore patients need new treatment options that exceed the benefit of classical chemotherapy.”
EXPAND is a multi-center, open label, randomized, controlled study taking place at 185 centers in 25 countries including Latin America, Europe, Asia-Pacific and Japan. The trial will assess the efficacy of Erbitux in combination with cisplatin and capecitabine chemotherapies as a first-line treatment for patients with advanced/metastatic gastric adenocarcinoma, including gastroesophageal junction (GEJ) adenocarcinoma. The primary endpoint of the study is progression-free survival determined by an independent review.
About Gastric Cancer
Gastric cancer, also known as stomach cancer, is the second leading cause of cancer death in men and the fourth among women worldwide. Generally, gastric cancer rates are about twice as high in men as in women.(4) Each year nearly 930,000 people worldwide are diagnosed with gastric cancer and approximately 700,000 die of the disease.(5)

Gastric cancer is notoriously difficult to treat and is associated with a poor prognosis. In resectable gastric cancer, surgery is potentially curative, but the majority of patients present with late stage disease and are therefore candidates for palliative chemotherapy only.
aEXPAND: Erbitux in combination with Xeloda and cisPlatin in AdvaNceD esophago-gastric cancer

1Pinto C, et al. Ann Oncol 2007;18:510-7.
2 Lordick F, et al. Br J Cancer 2010;102:500-5.
3 Moehler M, et al. Ann Oncol. Advance Access published November 30, 2010
4 American Cancer Society. Cancer Facts & Figures, 2007.
5 Parkin DM, et al. CA Cancer J Clin 2005;55:74–108.

For more information on Erbitux in colorectal and head & neck, please visit:

About Erbitux
Erbitux® is a first-in-class and highly active IgG1 monoclonal antibody targeting the epidermal growth factor receptor (EGFR). As a monoclonal antibody, the mode of action of Erbitux is distinct from standard non-selective chemotherapy treatments in that it specifically targets and binds to the EGFR. This binding inhibits the activation of the receptor and the subsequent signal-transduction pathway, which results in reducing both the invasion of normal tissues by tumor cells and the spread of tumors to new sites. It is also believed to inhibit the ability of tumor cells to repair the damage caused by chemotherapy and radiotherapy and to inhibit the formation of new blood vessels inside tumors, which appears to lead to an overall suppression of tumor growth.
The most commonly reported side effect with Erbitux is an acne-like skin rash that seems to be correlated with a good response to therapy. In approximately 5% of patients, hypersensitivity reactions may occur during treatment with Erbitux; about half of these reactions are severe.
Erbitux has already obtained market authorization in 82 countries. It has been approved for the treatment of colorectal cancer in 82 countries and for the treatment of squamous cell carcinoma of the head and neck (SCCHN) in 79 countries:

December 2003 (Switzerland), February 2004 (USA), June 2004 (EU) and followed by other countries: for use in combination with irinotecan in patients with EGFR-expressing mCRC (metastatic colorectal cancer) who have failed prior irinotecan therapy. In addition, Erbitux is also approved for single-agent use in further countries.
April 2006 (EU) and followed by other countries: for use in combination with radiotherapy for the treatment of locally advanced squamous cell carcinoma of the head and neck (SCCHN). In further countries, Erbitux is also approved as monotherapy in patients with recurrent and/or metastatic SCCHN who failed prior chemotherapy.
July 2008 (EU): license was updated for the treatment of patients with epidermal growth factor receptor (EGFR) expressing, KRAS wild-type mCRC in combination with chemotherapy and as a single agent in patients who have failed oxaliplatin-and irinotecan-based therapy and who are intolerant to irinotecan.
July 2008 (Japan): for use in combination with irinotecan in patients with EGFR-expressing mCRC who have failed prior irinotecan therapy
In November 2008 (EU): license was updated for the use in combination with platinum-based chemotherapy in patients with recurrent and/or metastatic SCCHN
March 2010 (Japan): label extended to use in combination with chemotherapy in the first-line treatment for patients with epidermal growth factor receptor (EGFR)-expressing, curatively unresectable (inoperable), advanced or recurrent colorectal cancer (mCRC) carrying the KRAS wild-type gene.

Merck licensed the right to market Erbitux outside the US and Canada from ImClone LLC, a wholly-owned subsidiary of Eli Lilly and Company, in 1998. In Japan, ImClone, Bristol-Myers Squibb Company and Merck jointly develop and commercialize Erbitux. Merck has an ongoing commitment to the advancement of oncology treatment and is currently investigating novel therapies in highly targeted areas, such as the use of Erbitux in colorectal cancer, squamous cell carcinoma of the head and neck and non-small cell lung cancer. Merck has also acquired the rights for the cancer treatment UFT® (tegafur-uracil) – an oral chemotherapy administered with folinic acid (FA) for the first-line treatment of metastatic colorectal cancer.

Merck is also investigating among other potential cancer treatments the use of Stimuvax® (BLP25 Liposome Vaccine) in the treatment of non-small cell lung cancer. The vaccine was granted fast-track status in September 2004 by the FDA. Merck obtained the exclusive worldwide licensing rights from Oncothyreon Inc., Seattle, Washington, USA.

In addition, Merck is developing cilengitide, which is the first in a new class of investigational anti-cancer therapies called integrin inhibitors to reach Phase III development; it is currently being investigated for the treatment of glioblastoma, SCCHN and NSCLC. Integrin inhibitors are thought to work by targeting the tumor and its vasculature.
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