The latest analysis of the E2211 Phase 2 trial from ECOG-ACRIN, the leading US multicenter clinical trials organization for cancer treatment, has been reported in the Journal of Clinical Oncology, a leading cancer journal. The study compared progression-free survival with temozolomide plus capecitabine versus temozolomide alone in patients with advanced pancreatic neuroendocrine tumors.

A total of 133 patients were enrolled, with 68 patients randomized to receive temozolomide plus capecitabine and 65 patients randomized to receive temozolomide alone.

At the interim assessment of treatment efficacy, median progression-free survival was 22.7 months in the temozolomide plus capecitabine arm compared to 14.4 months in the temozolomide alone arm. Response rates and overall survival were similar in the two treatment arms, but adverse events were more common in the temozolomide plus capecitabine arm.

In a subanalysis, the researchers concluded that low or absent expression of MGMT in cancer tissue was associated with a higher likelihood of benefit and warranted further study. Advanced pancreatic neuroendocrine tumors are relatively slow-growing cancers that have been known to respond poorly to drug therapy, but this study reports the results of a highly effective drug combination, and it is likely that the combination of temozolomide and capecitabine will become standard of care in the future.