Cargando…
Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck
Purpose: We sought to evaluate the efficacy and safety of the combination of cetuximab (Cmab) and paclitaxel (PTX) in patients with squamous cell carcinoma of the head and neck (SCCHN) who had unresectable recurrent or metastatic (R/M) disease after platinum-based chemoradiotherapy. Materials and Me...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119881/ https://www.ncbi.nlm.nih.gov/pubmed/30211118 http://dx.doi.org/10.3389/fonc.2018.00339 |
_version_ | 1783352153451003904 |
---|---|
author | Enokida, Tomohiro Okano, Susumu Fujisawa, Takao Ueda, Yuri Uozumi, Shinya Tahara, Makoto |
author_facet | Enokida, Tomohiro Okano, Susumu Fujisawa, Takao Ueda, Yuri Uozumi, Shinya Tahara, Makoto |
author_sort | Enokida, Tomohiro |
collection | PubMed |
description | Purpose: We sought to evaluate the efficacy and safety of the combination of cetuximab (Cmab) and paclitaxel (PTX) in patients with squamous cell carcinoma of the head and neck (SCCHN) who had unresectable recurrent or metastatic (R/M) disease after platinum-based chemoradiotherapy. Materials and Methods: Data on 23 patients with SCCHN who received paclitaxel and cetuximab (Cmab) for R/M disease no more than 6 months after CRT completion were retrospectively reviewed. PTX and Cmab were given in a 28-day cycle (PTX, 80 mg/m(2) on days 1, 8, and 15; Cmab, loading dose 400 mg/m(2) followed by a weekly 250 mg/m(2)). The differences in prognosis between subgroups in different clinical settings were also assessed. Results: CRT had been delivered as definitive treatment in 13 cases (57%) and as adjuvant treatment in 10 (43%). Median time from CRT completion to disease recurrence or metastasis was 73 days (1–152). The best objective response and disease control rates were 52 and 83%, respectively, with 12 partial responses and seven cases of stable disease by Response Evaluation Criteria in Solid Tumors (RECIST). A total of 17 of 23 patients (74%) achieved a degree of tumor shrinkage. Median progression-free survival (PFS) and overall survival (OS) were 7.0 (95% confidence interval [CI]: 3.7–8.4) and 16.3 months (95% CI: 7.8–23.3), respectively. Patients with a longer duration (≥60 d) from CRT completion to disease progression had a statistically significantly longer OS than the others (median OS 22.3 vs. 8.1 months, log-rank test; p = 0.034). Main Grade 3 toxicities included neutropenia (13%), anemia (13%), and hypomagnesemia (13%). No Grade 4 toxicity or treatment-related death was seen. Conclusion: PTX and Cmab is a tolerable and effective option in SCCHN patients with symptomatic CRT-refractory disease. Its favorable effects on tumor shrinkage will help relieve tumor-associated symptoms. |
format | Online Article Text |
id | pubmed-6119881 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-61198812018-09-12 Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck Enokida, Tomohiro Okano, Susumu Fujisawa, Takao Ueda, Yuri Uozumi, Shinya Tahara, Makoto Front Oncol Oncology Purpose: We sought to evaluate the efficacy and safety of the combination of cetuximab (Cmab) and paclitaxel (PTX) in patients with squamous cell carcinoma of the head and neck (SCCHN) who had unresectable recurrent or metastatic (R/M) disease after platinum-based chemoradiotherapy. Materials and Methods: Data on 23 patients with SCCHN who received paclitaxel and cetuximab (Cmab) for R/M disease no more than 6 months after CRT completion were retrospectively reviewed. PTX and Cmab were given in a 28-day cycle (PTX, 80 mg/m(2) on days 1, 8, and 15; Cmab, loading dose 400 mg/m(2) followed by a weekly 250 mg/m(2)). The differences in prognosis between subgroups in different clinical settings were also assessed. Results: CRT had been delivered as definitive treatment in 13 cases (57%) and as adjuvant treatment in 10 (43%). Median time from CRT completion to disease recurrence or metastasis was 73 days (1–152). The best objective response and disease control rates were 52 and 83%, respectively, with 12 partial responses and seven cases of stable disease by Response Evaluation Criteria in Solid Tumors (RECIST). A total of 17 of 23 patients (74%) achieved a degree of tumor shrinkage. Median progression-free survival (PFS) and overall survival (OS) were 7.0 (95% confidence interval [CI]: 3.7–8.4) and 16.3 months (95% CI: 7.8–23.3), respectively. Patients with a longer duration (≥60 d) from CRT completion to disease progression had a statistically significantly longer OS than the others (median OS 22.3 vs. 8.1 months, log-rank test; p = 0.034). Main Grade 3 toxicities included neutropenia (13%), anemia (13%), and hypomagnesemia (13%). No Grade 4 toxicity or treatment-related death was seen. Conclusion: PTX and Cmab is a tolerable and effective option in SCCHN patients with symptomatic CRT-refractory disease. Its favorable effects on tumor shrinkage will help relieve tumor-associated symptoms. Frontiers Media S.A. 2018-08-27 /pmc/articles/PMC6119881/ /pubmed/30211118 http://dx.doi.org/10.3389/fonc.2018.00339 Text en Copyright © 2018 Enokida, Okano, Fujisawa, Ueda, Uozumi and Tahara. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Enokida, Tomohiro Okano, Susumu Fujisawa, Takao Ueda, Yuri Uozumi, Shinya Tahara, Makoto Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck |
title | Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck |
title_full | Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck |
title_fullStr | Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck |
title_full_unstemmed | Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck |
title_short | Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck |
title_sort | paclitaxel plus cetuximab as 1st line chemotherapy in platinum-based chemoradiotherapy-refractory patients with squamous cell carcinoma of the head and neck |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119881/ https://www.ncbi.nlm.nih.gov/pubmed/30211118 http://dx.doi.org/10.3389/fonc.2018.00339 |
work_keys_str_mv | AT enokidatomohiro paclitaxelpluscetuximabas1stlinechemotherapyinplatinumbasedchemoradiotherapyrefractorypatientswithsquamouscellcarcinomaoftheheadandneck AT okanosusumu paclitaxelpluscetuximabas1stlinechemotherapyinplatinumbasedchemoradiotherapyrefractorypatientswithsquamouscellcarcinomaoftheheadandneck AT fujisawatakao paclitaxelpluscetuximabas1stlinechemotherapyinplatinumbasedchemoradiotherapyrefractorypatientswithsquamouscellcarcinomaoftheheadandneck AT uedayuri paclitaxelpluscetuximabas1stlinechemotherapyinplatinumbasedchemoradiotherapyrefractorypatientswithsquamouscellcarcinomaoftheheadandneck AT uozumishinya paclitaxelpluscetuximabas1stlinechemotherapyinplatinumbasedchemoradiotherapyrefractorypatientswithsquamouscellcarcinomaoftheheadandneck AT taharamakoto paclitaxelpluscetuximabas1stlinechemotherapyinplatinumbasedchemoradiotherapyrefractorypatientswithsquamouscellcarcinomaoftheheadandneck |