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Merck Serono launches Erbitux in Europe for head & neck cancer
Antwerp, Belgium | Saturday, January 24, 2009, 08:00 Hrs  [IST]

Merck Serono has announced the European launches of Erbitux for the 1st-line treatment of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN).

According to a company press release, leading oncology specialists and media gathered at the Antwerp University Hospital to mark the European launch of Erbitux (cetuximab) for the 1st-line treatment of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN), following European Commission approval to extend the use of the targeted therapy. Erbitux was previously approved for use in combination with radiotherapy for locally advanced SCCHN.

The approval of Erbitux in this new indication was granted in November 2008 and based primarily upon the results of the EXTREME study, published in the New England Journal of Medicine in September 2008. The EXTREME study established that adding Erbitux to platinum-based chemotherapy significantly prolonged median overall and progression-free survival, and also significantly increased response rate.

The principal investigator of the EXTREME trial, Professor Jan Vermorken from the Antwerp University Hospital, a world renowned centre of excellence in oncology research and treatment said: "We are pleased to be hosting the international launch of Erbitux in this notoriously difficult to treat cancer type. This is the first treatment regimen in 30 years to show a survival benefit and denotes a significant milestone in the advancement of treatment for head and neck cancer."

The EXTREME study demonstrated that patients treated with Erbitux plus chemotherapy experienced the following improvements, compared to chemotherapy alone:

Median overall survival increase of nearly 3 months (10.1 vs. 7.4 months; p=0.04), equating to a 20% reduction in the risk of death (HR: 0.80) during the study period 70% relative increase in median progression-free survival (5.6 vs. 3.3 months; p<0.001) Almost doubling of response rate (36% vs. 20%; p<0.001)

Concurrent with the launch of Erbitux, preliminary results were released from a new European survey "About Face", which was conducted by the European Head and Neck Society (EHNS) to investigate the awareness of head and neck cancer among the general public. The results showed alarmingly low levels of knowledge about the symptoms, risk factors and body parts affected by the disease despite it being the sixth-most common cancer worldwide.

In Europe alone, it is estimated that there are around 143,000 new cases of head and neck cancer and more than 68,000 deaths due to the disease each year. About 40% of patients with head and neck cancer have recurrent and/or metastatic SCCHN. Head and neck cancer includes cancers of the tongue, mouth, salivary glands, pharynx, larynx, sinuses and other sites located in the head and neck area. About 90% of head and neck cancers are of the squamous cell variety and nearly all express the epidermal growth factor receptor (EGFR) which is critical for tumour growth. Erbitux targets the EGFR. Although there have been significant improvements in chemotherapy and surgical techniques, the disease is particularly challenging to treat since most patients present with advanced disease and often have second primary tumours in addition to suffering from other co-morbidities. At least 75% of all head and neck cancers are attributed to two major risk factors, smoking and alcohol consumption.

"We are honoured to launch Erbitux in the 1st-line treatment for recurrent and/or metastatic SCCHN at a facility renowned for its pioneering work into head and neck cancer," said Dr Wolfgang Wein, Executive Vice President, Oncology, Merck Serono. "We hope that patients and specialists alike are encouraged by this first significant advance in this treatment setting in 30 years. Today's launch reinforces the impressive potential of Erbitux to extend patients' lives and further confirms the high activity of Erbitux against difficult to treat cancers."


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 tumour cells and the spread of tumours to new sites. It is also believed to inhibit the ability of tumour cells to repair the damage caused by chemotherapy and radiotherapy and to inhibit the formation of new blood vessels inside tumours, which appears to lead to an overall suppression of tumour 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.

Merck licensed the right to market Erbitux outside the US and Canada from ImClone Systems, a wholly-owned subsidiary of Eli Lilly and Company, in 1998. In Japan, ImClone Systems, 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 cancer treatments the use of Stimuvax (formerly referred to as 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., Bellevue, Washington, USA.

Merck Serono is the division for innovative prescription pharmaceuticals of Merck, a global pharmaceutical and chemical group. Headquartered in Geneva, Switzerland, Merck Serono discovers, develops, manufactures and markets innovative small molecules and biopharmaceuticals to help patients with unmet medical needs.

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