Authors' objectives: Evofosfamide is intended to be used as a first line treatment option for patients with locally advanced, unresectable or metastatic (late stage) pancreatic cancer. Evofosfamide is an intravenously administered, cytotoxic, hypoxia-activated prodrug (HAP), it is a nitromidazole-linked prodrug of dibromo isophoramide mustard, a potent DNA alkylator. Evofosfamide is essentially inactive under normal oxygen levels. The trigger molecule keeps the toxin inactive until it is in the hypoxic region of the tumour so as to prevent general toxicity and it is activated by the low oxygen concentrations thus killing cells in its vicinity. Evofosfamide is administered at 340mg/m² in combination with 1,000mg/m² gemcitabine, both via intravenous (IV) infusion over 30 minutes on days 1, 8 and 15 of every 28 day cycle. Pancreatic cancer affects both sexes equally, with a lifetime risk of I in 77 for men and 1 in 79 for women. In the UK, around 8,800 people were diagnosed with pancreatic cancer in 2011. Pancreatic cancer has one of the worst prognoses of all solid tumours with >95% of those affected dying of their disease. As the majority of pancreatic cancer is diagnosed at an advanced stage, the aim of treatment is usually palliative; to improve quality of life and relieve symptoms. Surgery with the intention of a cure is only possible in around one-fifth of new cases. Evofosfamide is currently in two phase III clinical trials in combination with gemcitabine comparing its effects on survival vs gemcitabine alone. These trials are expected to complete in 2014 and 2017.

Project Status: Completed

Year Published: 2015

URL for published report: http://www.hsric.nihr.ac.uk/topics/evofosfamide-for-locally-advanced-unresectable-or-metastatic-pancreatic-cancer-first-line-in-combination-with-gemcitabine/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Horizon Scanning Centre

Contact Address: The NIHR Horizon Scanning Centre, Department of Public Health, Epidemiology, and Biostatistics, School of Health and Population Sciences, University of Birmingham, 90 Vincent Drive, Edgbaston, Birmingham, B15 2SP. United Kingdom. Tel: +44 121 414 7831, Fax: +44 121 2269

Contact Name: c.packer@bham.ac.uk

Contact Email: c.packer@bham.ac.uk

Copyright: NIHR Horizon Scanning Research&Intelligence Centre (NIHR HSRIC)