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Guiard E, Clatot F, Even C, Perréard M, Abdeddaim C, Johnson A, Vauléon E, Rambeau A. Impact of previous nivolumab treatment on the response to taxanes in patients with recurrent/metastatic head and neck squamous cell carcinoma. Eur J Cancer 2021; 159:125-132. [PMID: 34743067 DOI: 10.1016/j.ejca.2021.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/25/2021] [Accepted: 09/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors are widely used in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). We aimed to describe response rates to taxanes after progression on nivolumab in R/M HNSCC patients. METHODS In this multicentric retrospective comparative study, we included patients treated with taxane monotherapy from 2014 to 2020. Patients were divided into two groups depending on whether they received nivolumab before taxanes (post-nivolumab group) or not (control group). The primary end-point was objective response rate (ORR) comparison between the two groups. The secondary end-points included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and PFS ratio (PFSr=PFS associated with taxanes divided by PFS associated with the previous line of treatment), a survival marker used for comparison of different treatment lines. RESULTS Between July 2014 and August 2020, 185 patients were included (114 in the control group and 71 in the post-nivolumab group). ORR was significantly higher in the post-nivolumab group (39.4% versus 26.3%, p = 0.03) as was DCR (69% versus 50%, P = 0.06). The median OS (7.5 months) and PFS (3.5 months) were not significantly different in the two groups, whereas PFSr was significantly improved in the post-nivolumab group (1.63 versus 1.11, P = 0.004). CONCLUSION Response and DCRs with taxanes are improved after prior exposure to nivolumab. Thus, taxane monotherapy could be a good choice as third-line therapy after nivolumab following a platinum-based first line. These results currently apply to patients without access to or potential benefit from first-line pembrolizumab.
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Affiliation(s)
- Emeline Guiard
- Medical Oncology Department, Centre François Baclesse, Caen, France.
| | - Florian Clatot
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France
| | - Caroline Even
- Head and Neck Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Marion Perréard
- Head and Neck Surgery Department, University Hospital, Caen, France
| | - Cyril Abdeddaim
- Medical Oncology Department, Centre Oscar Lambret, Lille, France
| | - Alison Johnson
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - Elodie Vauléon
- Medical Oncology Department, Centre Eugène Marquis, Rennes, France
| | - Audrey Rambeau
- Medical Oncology Department, Centre François Baclesse, Caen, France
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Kim MJ, Kim SM, Jung HA, Hong JY, Chang WJ, Choi MK, Kim HS, Sun JM, Park K, Ahn MJ. Efficacy and safety of cisplatin and weekly docetaxel in patients with recurrent or metastatic squamous cell carcinoma of the head and neck. Korean J Intern Med 2019; 34:1107-1115. [PMID: 29914230 PMCID: PMC6718762 DOI: 10.3904/kjim.2017.234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 02/07/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND/AIMS We investigated the efficacy and toxicity of a weekly schedule of docetaxel and cisplatin as a first-line treatment in patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). METHODS In this study, 18 patients with previously diagnosed R/M HNSCC were treated with combination chemotherapy of weekly docetaxel 35 mg/m2 (day 1 and 8) and cisplatin 70 mg/m2 (day 1) as first-line chemotherapy, repeated every 3 weeks. RESULTS Partial response and stable disease were observed in six patients (33.3%; 95% confidence interval [CI], 11.1% to 55.6%) and six patients (33.3%; 95% CI, 11.1% to 55.6%), respectively. The median overall survival and progression-free survival were 11.26 months (95% CI, 8.87 to 15.83) and 5.68 months (95% CI, 4.80 to 6.51), respectively. The major toxicity was grade 1/2 anemia (50%). Grade 3/4 neutropenia was observed in one patient (5.6%). Among the non-hematologic toxicities, grade 1/2 hepatotoxicity was most common (22.2%), and grade 3/4 infection was observed in one patient (5.6%). There was no treatment-related mortality. CONCLUSION For patients with R/M HNSCC, a cisplatin and weekly docetaxel regimen showed high efficacy with tolerable toxicity as a first-line treatment.
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Affiliation(s)
- Moon Jin Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Sung Min Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Hyun Ae Jung
- Division of Hematology-Oncology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Jung Yong Hong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Jin Chang
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Moon Ki Choi
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Hye Sook Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keunchil Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to Myung-Ju Ahn, M.D. Division of HematologyOncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-3438 Fax: +82-2-3410-1754 E-mail:
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Cohen EEW, Soulières D, Le Tourneau C, Dinis J, Licitra L, Ahn MJ, Soria A, Machiels JP, Mach N, Mehra R, Burtness B, Zhang P, Cheng J, Swaby RF, Harrington KJ. Pembrolizumab versus methotrexate, docetaxel, or cetuximab for recurrent or metastatic head-and-neck squamous cell carcinoma (KEYNOTE-040): a randomised, open-label, phase 3 study. Lancet 2019; 393:156-167. [PMID: 30509740 DOI: 10.1016/s0140-6736(18)31999-8] [Citation(s) in RCA: 980] [Impact Index Per Article: 196.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/16/2018] [Accepted: 08/22/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND There are few effective treatment options for patients with recurrent or metastatic head-and-neck squamous cell carcinoma. Pembrolizumab showed antitumour activity and manageable toxicity in early-phase trials. We aimed to compare the efficacy and safety of pembrolizumab versus standard-of-care therapy for the treatment of head-and-neck squamous cell carcinoma. METHODS We did a randomised, open-label, phase 3 study at 97 medical centres in 20 countries. Patients with head-and-neck squamous cell carcinoma that progressed during or after platinum-containing treatment for recurrent or metastatic disease (or both), or whose disease recurred or progressed within 3-6 months of previous multimodal therapy containing platinum for locally advanced disease, were randomly assigned (1:1) in blocks of four per stratum with an interactive voice-response and integrated web-response system to receive pembrolizumab 200 mg every 3 weeks intravenously or investigator's choice of standard doses of methotrexate, docetaxel, or cetuximab intravenously (standard-of-care group). The primary endpoint was overall survival in the intention-to-treat population. Safety was analysed in the as-treated population. This trial is registered with ClinicalTrials.gov, number NCT02252042, and is no longer enrolling patients. FINDINGS Between Dec 24, 2014, and May 13, 2016, 247 patients were randomly allocated to pembrolizumab and 248 were randomly allocated to standard of care. As of May 15, 2017, 181 (73%) of 247 patients in the pembrolizumab group and 207 (83%) of 248 patients in the standard-of-care group had died. Median overall survival in the intention-to-treat population was 8·4 months (95% CI 6·4-9·4) with pembrolizumab and 6·9 months (5·9-8·0) with standard of care (hazard ratio 0·80, 0·65-0·98; nominal p=0·0161). Fewer patients treated with pembrolizumab than with standard of care had grade 3 or worse treatment-related adverse events (33 [13%] of 246 vs 85 [36%] of 234). The most common treatment-related adverse event was hypothyroidism with pembrolizumab (in 33 [13%] patients) and fatigue with standard of care (in 43 [18%]). Treatment-related death occurred in four patients treated with pembrolizumab (unspecified cause, large intestine perforation, malignant neoplasm progression, and Stevens-Johnson syndrome) and two patients treated with standard of care (malignant neoplasm progression and pneumonia). INTERPRETATION The clinically meaningful prolongation of overall survival and favourable safety profile of pembrolizumab in patients with recurrent or metastatic head and neck squamous cell carcinoma support the further evaluation of pembrolizumab as a monotherapy and as part of combination therapy in earlier stages of disease. FUNDING Merck Sharp & Dohme, a subsidiary of Merck & Co.
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Affiliation(s)
- Ezra E W Cohen
- San Diego Moores Cancer Center, University of California, San Diego, CA, USA.
| | - Denis Soulières
- Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris, France; INSERM U900 Research Unit, Paris, France; Versailles-Saint-Quentin-en-Yvelines University, Paris, France
| | - José Dinis
- Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - Lisa Licitra
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; University of Milan, Milan, Italy
| | | | - Ainara Soria
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Jean-Pascal Machiels
- Cliniques Universitaires Saint-Luc, Brussels, Belgium; Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Nicolas Mach
- Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Ranee Mehra
- Fox Chase Cancer Center, Philadelphia, PA, USA (currently affiliated with Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA)
| | - Barbara Burtness
- Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA
| | | | | | | | - Kevin J Harrington
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, National Institute of Health Research Biomedical Research Centre, London, UK
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Abstract
Chemotherapy is the only option of treatment for most patients presenting with a recurrent and/or metastatic head and neck squamous cell carcinoma. The triple association of cisplatin, 5-fluorouracile, and cetuximab is still the current standard for fit patients. Other schemes are currently being compared with this protocol in ongoing trials and the association of cisplatin, docetaxel, and cetuximab appears to be the most efficient. The human papilloma virus is very likely a favorable prognostic factor. Immunotherapy with nivolumab or pembrolizumab is now a new standard of treatment in second line after yielding an improvement in overall survival, but predictive markers of efficacy are needed to refine the selection of patients. The combination of paclitaxel and buparlisib appears to be promising.
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Fayette J, Guigay J, Le Tourneau C, Degardin M, Peyrade F, Neidhardt EM, Sablin MP, Even C, Orlandini F, Juzyna B, Bellera C. Cabazitaxel in recurrent/metastatic squamous cell carcinoma of the head and neck: phase II UNICANCER trial ORL03. Oncotarget 2017; 8:51830-51839. [PMID: 28881692 PMCID: PMC5584293 DOI: 10.18632/oncotarget.15901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 01/23/2017] [Indexed: 12/26/2022] Open
Abstract
Treatments are limited after platinum Cetuximab or anti-PD1 failure for patients with recurrent/metastatic head and neck squamous cell carcinoma. Cabazitaxel has increased overall survival in hormone-refractory metastatic prostate cancer after failure of Docetaxel. Our aim was to detect a signal of activity with Cabazitaxel in patients with head and neck cancer who had failed platinum-, Cetuximab- and taxanes-based chemotherapy. This multicenter phase II trial included progressive patients with an ECOG ≤2. Cabazitaxel was given at 25 mg/m2/3 weeks (maximum of 10 cycles), with growth factors support. Efficacy was centralized and assessed every 6 weeks. The primary endpoint was control rate at six-weeks. A Simon’s two-stage optimal design (P0=0.10; P1=0.30) required 29 evaluable patients. At the end of trial, at least 6 non-progressions were required to consider the drug worthy of further study. Out of the 31 enrolled patients, 29 were eligible; 42% had received at least three previous lines of chemotherapy. For the primary end point, 8 patients (27.6%; 95%CI 12.7%-47.2%) had a stable disease at six weeks. Median progression-free survival was 1.05 months (95%CI 0.69-2.07). All patients were analyzed for toxicity: 6 patients had febrile neutropenia. During the 81 cycles administered, 49 grade 3-5 events were observed concerning 81% of the patients, including 35 severe adverse events of which 15 were related to Cabazitaxel. Although Cabazitaxel met its primary endpoint to deserve further investigations, its toxicity makes it difficult to use in frail patients and new schemes are needed (20 mg/m2 for example) if further investigations are launched.
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Affiliation(s)
| | - Joel Guigay
- Gustave Roussy Institute, Villejuif, France.,Antoine Lacassagne Center, Nice, France
| | - Christophe Le Tourneau
- Institut Curie, Saint-Cloud & Paris, France.,EA7285, Versailles-Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
| | | | | | | | | | | | | | | | - Carine Bellera
- Bergonié Institute, Clinical and Epidemiological Research Unit & INSERM U897 & Data Center for Cancer Clinical Trials, Bordeaux, France
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Pellini Ferreira B, Redman M, Baker KK, Martins R, Eaton KD, Chow LQM, Baik CS, Goulart B, Lee SM, Santana-Davila R, Rodriguez CP. Predictors of outcome with cetuximab and paclitaxel for head and neck squamous cell carcinoma. Laryngoscope 2016; 127:1583-1588. [DOI: 10.1002/lary.26422] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/26/2016] [Accepted: 10/17/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Bruna Pellini Ferreira
- Department of Medicine; University of Central Florida College of Medicine; Orlando Florida U.S.A
| | - Mary Redman
- Clinical Research Division; Fred Hutchinson Cancer Research Center; Seattle Washington U.S.A
| | - Kelsey K. Baker
- Clinical Research Division; Fred Hutchinson Cancer Research Center; Seattle Washington U.S.A
| | - Renato Martins
- Department of Medicine, Division of Medical Oncology; University of Washington; Seattle Washington U.S.A
| | - Keith D. Eaton
- Department of Medicine, Division of Medical Oncology; University of Washington; Seattle Washington U.S.A
| | - Laura Quan Man Chow
- Department of Medicine, Division of Medical Oncology; University of Washington; Seattle Washington U.S.A
| | - Christina S. Baik
- Department of Medicine, Division of Medical Oncology; University of Washington; Seattle Washington U.S.A
| | - Bernardo Goulart
- Department of Medicine, Division of Medical Oncology; University of Washington; Seattle Washington U.S.A
| | - Sylvia Mina Lee
- Department of Medicine, Division of Medical Oncology; University of Washington; Seattle Washington U.S.A
| | - Rafael Santana-Davila
- Department of Medicine, Division of Medical Oncology; University of Washington; Seattle Washington U.S.A
| | - Cristina P. Rodriguez
- Department of Medicine, Division of Medical Oncology; University of Washington; Seattle Washington U.S.A
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Péron J, Polivka V, Chabaud S, Poupart M, Ceruse P, Ramade A, Girodet D, Zrounba P, Fayette J. An effective and well-tolerated strategy in recurrent and/or metastatic head and neck cancer: successive lines of active chemotherapeutic agents. BMC Cancer 2014; 14:504. [PMID: 25011678 PMCID: PMC4096421 DOI: 10.1186/1471-2407-14-504] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The combination platinum, 5-fluorouracil (5-FU) and cetuximab is the standard first-line regimen of recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC). Due to the toxicity of this treatment, alternative therapies are often offered to patients. The aim of this study was to evaluate the overall survival obtained with a first line chemotherapy adapted to patients functional status and the administration of all active drugs within successive lines of chemotherapy. METHODS This series included a total of 194 patients with recurrent and/or metastatic HNSCC treated from 2006 to 2011 in a single institution where the administration of successive lines of chemotherapies has been the standard clinical approach. Treatment was administered according to clinical practice guidelines. RESULTS Most patients received at least two treatment lines. Only 11 patients (6%) were treated with a combination of cisplatin, 5-FU and cetuximab in front line, but most patients received at least one platinum-based regimen (n = 154 patients, 78%); 162 (82%) received taxanes, 36 (18%) received 5-FU, 27 (14%) received capecitabine, 67 (34%) received methotrexate and 134 (68%) received cetuximab. The median overall survival was 9.8 months (95% CI: 8.1-11.4 months) and reached 13.1 months among the subgroup of 131 patients eligible for inclusion in a clinical trial. CONCLUSION The survival outcomes of patients treated in the first-line setting with chemotherapy regimens adapted to their functional status, followed by several subsequent regimens were comparable with published outcomes of patients treated by platinum, 5-FU and cetuximab.
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Affiliation(s)
- Julien Péron
- Department of Medical Oncology, Centre Léon Bérard, University of Lyon, Lyon, France
- Hospices Civils de Lyon, Service de Biostatistique, F-69003 Lyon, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
| | - Valentine Polivka
- Department of Biostatistics, University of Lyon, Centre Léon Bérard, Lyon, France
| | - Sylvie Chabaud
- Department of Biostatistics, University of Lyon, Centre Léon Bérard, Lyon, France
| | - Marc Poupart
- University of Lyon, Department of Otorhinolaryngology, Hôpital de la Croix-Rousse, Lyon, France
| | - Philippe Ceruse
- Department of Otorhinolaryngology, Centre Hospitalier Lyon Sud, University of Lyon, Pierre-Bénite, Lyon, France
- Department of Otorhinolaryngology, Hôpital E Herriot, University of Lyon, Lyon, France
| | - Antoine Ramade
- Department of Otorhinolaryngology, Hôpital E Herriot, University of Lyon, Lyon, France
| | - Didier Girodet
- Department of Otorhinolaryngology, Centre Léon Bérard, University of Lyon, Lyon, France
| | - Philippe Zrounba
- Department of Otorhinolaryngology, Centre Léon Bérard, University of Lyon, Lyon, France
| | - Jérôme Fayette
- Department of Medical Oncology, Centre Léon Bérard, University of Lyon, Lyon, France
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Bejar C, Maubec E. Therapy of Advanced Squamous Cell Carcinoma of the Skin. Curr Treat Options Oncol 2014; 15:302-20. [DOI: 10.1007/s11864-014-0280-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Specenier PM, Vermorken JB. Recurrent head and neck cancer: current treatment and future prospects. Expert Rev Anticancer Ther 2014; 8:375-91. [DOI: 10.1586/14737140.8.3.375] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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10
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Outcome of patients treated with palliative weekly Paclitaxel plus Cetuximab in recurrent head and neck cancer after failure of platinum-based therapy. Eur Arch Otorhinolaryngol 2013; 271:373-8. [DOI: 10.1007/s00405-013-2537-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/25/2013] [Indexed: 10/26/2022]
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Argiris A, Ghebremichael M, Gilbert J, Lee JW, Sachidanandam K, Kolesar JM, Burtness B, Forastiere AA. Phase III randomized, placebo-controlled trial of docetaxel with or without gefitinib in recurrent or metastatic head and neck cancer: an eastern cooperative oncology group trial. J Clin Oncol 2013; 31:1405-14. [PMID: 23460714 DOI: 10.1200/jco.2012.45.4272] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
PURPOSE We hypothesized that the addition of gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, to docetaxel would enhance therapeutic efficacy in squamous cell carcinoma of the head and neck (SCCHN). PATIENTS AND METHODS Patients with recurrent or metastatic SCCHN with Eastern Cooperative Oncology Group (ECOG) performance status of 2, or patients with ECOG performance status of 0 to 2 but were previously treated with chemotherapy, were randomly assigned to receive weekly docetaxel plus either placebo (arm A) or gefitinib 250 mg/d, orally (arm B) until disease progression. At the time of progression, patients in the placebo arm could receive single-agent gefitinib. EGFR, c-MET, and KRAS mutations and polymorphisms in drug metabolizing enzymes and transporters were evaluated by pyrosequencing. RESULTS Two hundred seventy patients were enrolled before the study was closed early at interim analysis (arm A, n = 136; arm B, n = 134). Median overall survival was 6.0 months in arm A versus 7.3 months in arm B (hazard ratio, 0.93; 95% CI, 0.72 to 1.21; P = .60). An unplanned subset analysis showed that gefitinib improved survival in patients younger than 65 years (median 7.6 v 5.2 months; P = .04). Also, there was a trend for improved survival in patients with c-MET wild-type (5.7 v 3.6 months; P = .09) regardless of treatment. Grade 3/4 toxicities were comparable between the two arms except that grade 3/4 diarrhea was more common with docetaxel/gefitinib. Of 18 eligible patients who received gefitinib after disease progression in arm A, one patient had a partial response. CONCLUSION The addition of gefitinib to docetaxel was well tolerated but did not improve outcomes in poor prognosis but otherwise unselected patients with SCCHN.
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Affiliation(s)
- Athanassios Argiris
- Division of Hematology/Oncology, University of Texas Health Science Center at San Antonio, Cancer Therapy and Research Center, 7979 Wurzbach Rd, MC8232, Zeller Building, 4th Floor, Room Z418, San Antonio, TX 78229, USA.
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Knoedler M, Gauler T, Gruenwald V, Matzdorff A, Schroeder M, Dietz A, Jordan WO, Arnold D, Hennemann B, Hofele C, Weissinger F, Eberhardt W, Keilholz U. Phase II Study of Cetuximab in Combination with Docetaxel in Patients with Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck after Platinum-Containing Therapy: A Multicenter Study of the Arbeitsgemeinschaft Internistische Onkologie. Oncology 2013; 84:284-9. [DOI: 10.1159/000345453] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 10/23/2012] [Indexed: 11/19/2022]
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Park Y, Kim DS, Park KH, Baek SK, Kwon SY, Shin SW, Jung KY, Kim CY, Kim YH, Lee NJ, Kim JS, Kim IS. RASSF1A and ERCC1 expression levels might be predictive of prognosis in advanced, recurrent, and metastatic squamous cell carcinoma of the head and neck treated with docetaxel and cisplatin. ACTA ACUST UNITED AC 2012; 35:673-82. [PMID: 23147544 DOI: 10.1159/000343636] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The purpose of this study was to test the hypothesis that the immunohistochemical expression of ERCC1 and RASSF1A would predict both response to and survival after docetaxel and cisplatin combination chemotherapy in inoperable or recurrent head and neck squamous cell carcinoma. PATIENTS AND METHODS A total of 54 patients were treated with frontline systemic chemotherapy composed of docetaxel (60 mg/m(2)) and cisplatin (65 mg/m(2)), every 3 weeks for up to 6 cycles. The expression levels of ERCC1 and RASSF1A were evaluated in the available 36 prechemotherapy samples. RESULTS The overall objective response rate was 35% (complete remission 12% and partial remission 23%). The median progression-free survival and overall survival (OS) times were 5.0 months (95% confidence interval (CI), 3.7-6.4 months) and 24.2 months (95% CI, 3.5-45.0 months), respectively. The status of low ERCC1 and high RASSF1A expression was an independent favorable prognostic factor for OS in multivariate analysis (p = 0.043; hazard ratio, 7.224; 95% CI, 1.060-49.217). Toxicities were comparable with those of previously reported trials. CONCLUSIONS Less intensive doses of cisplatin and docetaxel are active but not effective in reducing toxicity. Also, both ERCC1 and RASSF1A might be useful prognostic markers in this regimen.
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Affiliation(s)
- Yong Park
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Weekly Docetaxel in Patients With Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck. Am J Clin Oncol 2011; 34:472-7. [DOI: 10.1097/coc.0b013e3181ec5f16] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Chang PMH, Tzeng CH, Chen MH, Tsao CJ, Su WC, Hwang WS, Chang YF, Chang SY, Yang MH. Triweekly reduced-dose docetaxel combined with cisplatin in recurrent/metastatic head and neck squamous cell carcinoma: a multicenter phase II study. Cancer Chemother Pharmacol 2011; 68:1477-84. [DOI: 10.1007/s00280-011-1645-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Accepted: 03/28/2011] [Indexed: 10/18/2022]
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Vermorken J, Specenier P. Optimal treatment for recurrent/metastatic head and neck cancer. Ann Oncol 2010; 21:vii252-vii261. [DOI: 10.1093/annonc/mdq453] [Citation(s) in RCA: 229] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Paclitaxel is effective in relapsed head and neck squamous cell carcinoma: a retrospective study of 66 patients at a single institution. Anticancer Drugs 2010; 21:553-8. [DOI: 10.1097/cad.0b013e3283388e60] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rathore R, Birnbaum A, Rathore B, DiPetrillo T, Kennedy T, Ready N. Carboplatin with weekly docetaxel and ifosfamide in advanced head and neck cancers: a phase I Brown University Oncology Group dose escalation study (HN-93). Cancer Chemother Pharmacol 2010; 66:1013-7. [PMID: 20130878 DOI: 10.1007/s00280-010-1251-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 01/11/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE A phase I study was performed to determine the maximally tolerated dose of carboplatin, ifosfamide, and docetaxel in advanced head and neck cancers. METHODS Carboplatin (week 1) was administered with weekly docetaxel and ifosfamide for 3 weeks in an every 4-week cycle. Restaging was done after two cycles, while dose level escalation was done in cohorts of three patients. RESULTS Fifteen patients (recurrent/metastatic disease, n = 8; bulky locally advanced disease, n = 7) were enrolled. No dose-limiting toxicities were observed. Toxicities included grade 3 neutropenia and anemia (n = 2, each), and grade 2 thrombocytopenia (n = 3). The final level of carboplatin AUC = 6 (week 1) with docetaxel 30 mg/m(2) per week and ifosfamide 1,000 mg/m(2) per week was chosen for further evaluation. CONCLUSIONS This novel regimen of carboplatin with weekly docetaxel and ifosfamide has a favorable toxicity profile and is active in this setting. Phase II study results are awaited.
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Affiliation(s)
- Ritesh Rathore
- Division of Hematology/Oncology, Roger Williams Hospital, 825 Chalkstone Avenue, Providence, RI 02908, USA.
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Argiris A, Buchanan A, Brockstein B, Kolesar J, Ghebremichael M, Pins M, Hahn K, Axelrod R, Forastiere A. Docetaxel and irinotecan in recurrent or metastatic head and neck cancer: a phase 2 trial of the Eastern Cooperative Oncology Group. Cancer 2009; 115:4504-13. [PMID: 19634157 DOI: 10.1002/cncr.24528] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Docetaxel and irinotecan have single-agent antitumor activity in squamous cell carcinoma of the head and neck (SCCHN). The authors sought to evaluate their combination in the treatment of patients with recurrent or metastatic SCCHN. METHODS Eligibility criteria included recurrent or metastatic SCCHN with measurable disease, good performance status, and adequate laboratory parameters. Patients received docetaxel 35 mg/m(2) and irinotecan 60 mg/m(2), intravenously, on Days 1 and 8, every 21 days, until disease progression. The authors assessed UGT1A1 genotype, vascular endothelial growth factor (VEGF) in serum, and cyclooxygenase-2 and VEGF in baseline tumor tissue. RESULTS Fifty-two patients were analyzable: 20 chemotherapy naive (Group A) and 32 previously treated with 1 chemotherapy regimen (Group B); 73% of patients had distant metastasis, and 60% were paclitaxel-exposed. In Group A, 3 (15%) patients achieved a partial response; in Group B, 1 (3%) patient achieved a partial response. Median progression-free survival (PFS) and overall survival were 3.3 and 8.2 months in Group A and 1.9 and 5.0 months in Group B, respectively. Common serious toxicities were diarrhea, fatigue, and anorexia. Patients with high serum VEGF had a median PFS of 2.8 months versus 1.7 months for patients with low VEGF (P = .085). CONCLUSIONS Docetaxel and irinotecan had acceptable toxicities, but efficacy results in unselected patients with recurrent or metastatic SCCHN did not suggest an advantage over docetaxel alone or platinum-based regimens.
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Affiliation(s)
- Athanassios Argiris
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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Grau JJ, Caballero M, Verger E, Monzó M, Blanch JL. Weekly paclitaxel for platin-resistant stage IV head and neck cancer patients. Acta Otolaryngol 2009; 129:1294-9. [PMID: 19863327 DOI: 10.3109/00016480802590451] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CONCLUSIONS Weekly paclitaxel may be an active and well tolerated chemotherapy regimen for patients with platin-resistant advanced head and neck cancer. OBJECTIVES Weekly paclitaxel should be an active and well tolerated regimen for palliative treatment of platin-resistant patients with recurrent or metastatic carcinoma of the head and neck. We analyzed the antitumor activity and toxicity profile. PATIENTS AND METHODS Sixty consecutive patients with advanced head and neck cancer were treated with 1 h infusion of paclitaxel, 80 mg/m(2) weekly, for 6 consecutive weeks. Patients who showed disease response or disease stabilization continued until progression of disease. RESULTS A total of 719 doses of paclitaxel were administered to the 60 patients. No complete response was observed. Partial response and stable disease were observed in 26 (43.3%) and 9 (15%) patients, respectively. Median time to tumor progression for patients who responded to therapy was 6.2 months (SD=1.3; 95% CI, 3.7-8.6) and the overall median survival in this group of patients was 8.5 months (SD=1.4; 95% CI, 5.7-11.2). The main toxic effects were leukopenia (26.6%), anemia (43.3%), fatigue (37.4%), alopecia (18.7%), rash/desquamation (13.3%), and thrombophlebitis (6.8%).
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Affiliation(s)
- Juan José Grau
- Oncology Department, Institut Clinic de Malalties Hemato-Oncologiques, University of Barcelona, Augusto Pi i Sunyer Memorial Institute for Biomedical Research, Hospital Clinic of Barcelona, Villarroel St 170, Barcelona, Spain
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Cho BC, Keum KC, Shin SJ, Choi HJ, Lee YJ, Kim SH, Choi EC, Kim JH. Weekly docetaxel in patients with platinum-refractory metastatic or recurrent squamous cell carcinoma of the head and neck. Cancer Chemother Pharmacol 2009; 65:27-32. [DOI: 10.1007/s00280-009-0999-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2009] [Accepted: 04/03/2009] [Indexed: 10/20/2022]
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Rapidis A, Sarlis N, Lefebvre JL, Kies M. Docetaxel in the treatment of squamous cell carcinoma of the head and neck. Ther Clin Risk Manag 2008; 4:865-86. [PMID: 19209269 PMCID: PMC2621396 DOI: 10.2147/tcrm.s3133] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Squamous cell carcinoma of the head and neck (SCCHN) presents at a locally advanced (LA) stage in many patients. Chemotherapy has been successfully integrated into first-line treatment programs, either during or prior to radiotherapy (RT) - the cornerstone modality for local disease control of inoperable disease or when organ preservation is desired. Concomitant chemoradiotherapy (CCRT) provides an absolute survival benefit when compared with other types of locoregional therapy that exclude chemotherapy. Nonetheless, distant metastases still represent the most common cause of treatment failure. Consequently, adding induction chemotherapy (ICT) to definitive non-surgical local therapies with a curative intent has been vigorously explored in LA SCCHN. Recently, it has been shown that ICT using the combination of the taxane docetaxel with cisplatin-5-fluorouracil provides significant survival benefit over cisplatin-5-FU, when used before either definitive RT (TAX323 trial) or carboplatin-based CCRT (TAX324 trial). Docetaxel is also being investigated in metastatic or recurrent (M/R) disease, with promising initial results. It is very likely that the future management strategies of SCCHN will incorporate biologic agents as an add-on to docetaxel-containing schemas, administered either as ICT prior to CCRT in the LA setting or for the management of M/R disease.
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Affiliation(s)
- Alexander Rapidis
- Department of Maxillofacial Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens, Greece
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Garnett CT, Schlom J, Hodge JW. Combination of docetaxel and recombinant vaccine enhances T-cell responses and antitumor activity: effects of docetaxel on immune enhancement. Clin Cancer Res 2008; 14:3536-44. [PMID: 18519787 DOI: 10.1158/1078-0432.ccr-07-4025] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Taxanes comprise some of the most widely used cancer chemotherapeutic agents. Members of this drug family, including docetaxel, are commonly used to treat breast, prostate, and lung cancers, among others. This study was designed to determine if this taxane has the ability to modulate components of the immune system independent of antitumor activity and to investigate the potential synergistic activities of the combination of docetaxel and vaccine therapy. EXPERIMENTAL DESIGN We examined the in vivo effects of docetaxel on immune-cell subsets and on the function of CD4+, CD8+, and regulatory T-cell (Treg) populations in response to antigen-specific vaccination. We also examined the antitumor effects of the combination of docetaxel and vaccine in a preclinical model in which docetaxel has no observable effect on tumor growth. RESULTS These studies show for the first time that (a) docetaxel modulates CD4+, CD8+, CD19+, natural killer cell, and Treg populations in non-tumor-bearing mice; (b) unlike cyclophosphamide, docetaxel does not inhibit the function of Tregs; (c) docetaxel enhances CD8+ but not CD4+ response to CD3 cross-linking; (d) docetaxel given after vaccination provides optimal enhancement of immune response to recombinant viral vaccines; (e) docetaxel combined with recombinant viral vaccine is superior to either agent alone at reducing tumor burden; and (f) docetaxel plus vaccine increases antigen-specific T-cell responses to antigen in the vaccine, as well as to cascade antigens derived from the tumor. CONCLUSIONS These findings suggest potential clinical benefit for the combined use of docetaxel and recombinant cancer vaccines.
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Affiliation(s)
- Charlie T Garnett
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
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Seiwert TY, Cohen EEW, Haraf DJ, Stenson K, Blair EA, Mauer A, Dekker A, Vokes EE. A phase I trial of docetaxel based induction and concomitant chemotherapy in patients with locally advanced head and neck cancer. Cancer Invest 2007; 25:435-44. [PMID: 17882655 DOI: 10.1080/07357900701357993] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to determine the maximum tolerated dose (MTD) of docetaxel based induction and concomitant chemoradiotherapy (CRT) after using the FHX platform (5 = 5-FU, H = hydroxyurea, X = Radiation). Patients with Stage III/IV locally advanced HNSCC were enrolled. Induction chemotherapy (carboplatin/docetaxel) was followed by 5 cycles of concomitant docetaxel based CRT. No DLTs were observed in dose levels 1/2 for induction and CRT. Dose level 2 was expanded. The overall survival CR rate after CRT was 79 percent. Median overall (OS) has not been reached and 2-year OS is 80.7 percent. The recommended Phase II dose of docetaxel with FHX CRT is 25 mg/m(2) and 35 mg/m(2) in combination with carboplatin induction (AUC = 6).
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Affiliation(s)
- Tanguy Y Seiwert
- Section of Hematology/Oncology, University of Chicago, Chicago, Illinois 60637, USA
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Specenier PM, Vermorken JB. Neoadjuvant chemotherapy in head and neck cancer: Should it be revisited? Cancer Lett 2007; 256:166-77. [PMID: 17673364 DOI: 10.1016/j.canlet.2007.06.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Revised: 06/16/2007] [Accepted: 06/20/2007] [Indexed: 11/23/2022]
Abstract
Locally advanced SCCHN (LA-SCCHN) is generally treated by a combination of chemotherapy, irradiation and/or surgery. Timing of the chemotherapy has for long been a matter of debate but concurrent chemoradiation was widely adopted as standard of care for locally advanced squamous cell carcinoma of the head and neck after the publication of a large meta-analysis which demonstrated that concurrent chemoradiation confers an absolute survival benefit of 8% at 2 and 5 years. Induction chemotherapy has some appealing advantages including the opportunity of assessing tumor response and selecting the patients who are candidates for organ preservation. The cisplatin-fluorouracil combination has been the induction regimen of choice for two decades but has recently been superseded by a combination of cisplatin, fluorouracil and a taxane which can be considered the standard regimen when induction chemotherapy is appropriate. Multiple large randomized trials designed to compare sequential induction, i.e., chemotherapy followed by CRT to CRT alone are currently underway. New challenges are the integration of targeted therapies into the current treatment strategies and the identification of prognostic biomarkers and of factors predicting the response to treatment which would help to select patients who are likely to benefit most from induction chemotherapy.
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Affiliation(s)
- Pol M Specenier
- Department of Medical Oncology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium
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Willey CD, Murphy BA, Netterville JL, Burkey BB, Shyr Y, Shakhtour B, Kish B, Raben D, Chen C, Song JI, Kane MA, Cmelak AJ. A Phase II multi-institutional trial of chemoradiation using weekly docetaxel and erythropoietin for high-risk postoperative head and neck cancer patients. Int J Radiat Oncol Biol Phys 2007; 67:1323-31. [PMID: 17289289 DOI: 10.1016/j.ijrobp.2006.11.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2006] [Revised: 11/14/2006] [Accepted: 11/17/2006] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine efficacy and toxicities of postoperative concurrent chemoradiation using docetaxel in high-risk head and neck cancer. METHODS AND MATERIALS High-risk patients were enrolled 2-8 weeks after surgery. Treatment included 60 Gy for 6 weeks with weekly docetaxel 25 mg/m(2) and erythropoietin alpha 40,000 U for hemoglobin < or =12 g/dL. Primary endpoints included locoregional control (LC), disease-free survival (DFS), and patterns of failure (POF). Secondary endpoints were toxicity and quality of life. RESULTS Eighteen patients were enrolled (14 male, 4 female), aged 24-70 years (median, 55 years). Primary site included oropharynx = 7, oral cavity = 8, hypopharynx = 1, and larynx = 2. Pathologic American Joint Committee on Cancer Stage was III = 3 patients, IV = 15 patients. High-risk eligibility included > or =2 positive lymph nodes = 13, extracapsular extension = 10, positive margins = 8 (11 patients with two or more risk factors). Docetaxel was reduced to 20 mg/m(2)/week after 5 patients had prolonged Grade 3 or higher mucositis. Overall, number of doses delivered was 2 of 6 = 1, 3 of 6 = 2, 4 of 6 = 2, 5 of 6 = 4, 6 of 6 = 9 patients. With median follow-up of 30 months (range, 5-66), 10 (56%) patients are alive and have no evidence of disease (NED); POF: three local recurrences (two with distant) and 1 distant only. One-year survival was 76%, median PFS and DFS had not been reached. Three-year LC was 82%. No Grade 3 or higher late toxicities were observed, although a few cases of prolonged mucositis and taste loss (>3 months) were seen, particularly at 25 mg/m(2)/week. CONCLUSION Postoperative radiation therapy with weekly docetaxel 20 or 25 mg/m(2)/week for high-risk postoperative head and neck cancer caused intolerable mucosal toxicity, prompting early study termination. Further studies should consider 15 mg/m(2). Actuarial 3-year LC is 82%, similar to cisplatin-based chemoradiation regimens. Distant metastasis remains an important issue requiring additional systemic interventions.
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Affiliation(s)
- Christopher D Willey
- Department of Radiation Oncology, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee 37232, USA
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