Induction docetaxel, Cisplatin, and cetuximab followed by concurrent radiotherapy, Cisplatin, and cetuximab and maintenance cetuximab in patients with locally advanced head and neck cancer.
Summary of "Induction docetaxel, Cisplatin, and cetuximab followed by concurrent radiotherapy, Cisplatin, and cetuximab and maintenance cetuximab in patients with locally advanced head and neck cancer."
PURPOSE We incorporated cetuximab, a chimeric monoclonal antibody against the epidermal growth factor receptor (EGFR), into the induction therapy and subsequent chemoradiotherapy of head and neck cancer (HNC). PATIENTS AND METHODS Patients with locally advanced HNC, including squamous and undifferentiated histologies, were treated with docetaxel 75 mg/m(2) day 1, cisplatin 75 mg/m(2) day 1, and cetuximab 250 mg/m(2) days 1, 8, and 15 (after an initial loading dose of 400 mg/m(2)), termed TPE, repeated every 21 days for three cycles, followed by radiotherapy with concurrent cisplatin 30 mg/m(2) and cetuximab weekly (XPE), and maintenance cetuximab for 6 months. Quality of life (QOL) was assessed using Functional Assessment of Cancer Therapy-Head and Neck. In situ hybridization (ISH) for human papillomavirus (HPV), immunohistochemistry for p16, and fluorescence ISH for EGFR gene copy number were performed on tissue microarrays. Results Of 39 enrolled patients, 36 had stage IV disease and 23 an oropharyngeal primary. Acute toxicities during TPE included neutropenic fever (10%) and during XPE, grade 3 or 4 oral mucositis (54%) and hypomagnesemia (39%). With a median follow-up of 36 months, 3-year progression-free survival and overall survival were 70% and 74%, respectively. Eight patients progressed in locoregional sites, three in distant, and one in both. HPV positivity was not associated with treatment efficacy. No progression-free patient remained G-tube dependent. The H&N subscale QOL scores showed a significant decrement at 3 months after XPE, which normalized at 1 year. CONCLUSION This cetuximab-containing regimen resulted in excellent long-term survival and safety, and warrants further evaluation in both HPV-positive and -negative HNC.
Affiliation
FACP, 5150 Centre Ave, University of Pittsburgh Medical Center Cancer Pavilion, 5th Floor, Pittsburgh, PA 15232; argirisae@upmc.edu.
Journal Details
This article was published in the following journal.
Name: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
ISSN: 1527-7755
Pages: 5294-300
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21079141
- DOI: http://dx.doi.org/10.1200/JCO.2010.30.6423
Medical and Biotech [MESH] Definitions
Cisplatin
An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle.
Ondansetron
A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and has reported anxiolytic and neuroleptic properties.
Radiotherapy, Adjuvant
Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
Radiotherapy Dosage
The total amount of radiation absorbed by tissues as a result of radiotherapy.
Radiotherapy, Conformal
Radiotherapy where there is improved dose homogeneity within the tumor and reduced dosage to uninvolved structures. The precise shaping of dose distribution is achieved via the use of computer-controlled multileaf collimators.
PubMed Articles
BACKGROUND: In stage III non-small-cell lung cancer (NSCLC), the role of systemic chemotherapy preceding or following concurrent chemo-radiotherapy (CT-RT) is unclear. We carried out a randomized phas...
PURPOSE: To evaluate the feasibility and efficacy of neoadjuvant chemotherapy involving docetaxel and cisplatin followed by intensity-modulated radiotherapy (IMRT) with concurrent cisplatin in patient...
Abstract Background: Cetuximab (Erbitux * *Erbitux is a registered trade name of Bristol?Myers Squibb, Princeton, NJ, USA. ) is the only new medical therapy for locally and regionally advance...
BACKGROUND: Concurrent chemoradiotherapy (CRT) is a main treatment option for patients with advanced oesophageal cancer. However, improvement of survival outcomes and toxicities according to the selec...
The aim of this study was to evaluate the efficacy and tolerability of the combination of cisplatin-gemcitabine with concurrent thoracic radiotherapy for locally advanced non-small cell lung cancer (L...
Clinical Trials
To evaluate the progression free time in patients with completed or partial response > 30% evaluated over primary tumour (damage T and N) after induction TPF (Docetaxel, Cisplatin, 5-FU)...
Phase II, randomised, controlled, non comparative study with 2 parallel groups: - Arm A: patients will receive induction chemotherapy (cisplatin and docetaxel) followed by a conco...
- Primary : To determine the safety profile of each treatment group. - Secondary : To determine efficacy in term of overall response, disease free survival and survival at 1 and...
The purpose of this study is to determine if the addition of a unique targeted agent called Cetuximab (also known as "C225" and "Erbitux") can increase the effectiveness of standard treatm...
This phase two trial will determine the tumor response rate at the primary site and at involved regional nodes to two cycles of an IC regimen of weekly Abraxane and cetuximab given in comb...
