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Ota Y, Kodaira T, Fujii H, Shimokawa M, Yokota T, Nakashima T, Monden N, Homma A, Ueda S, Akimoto T. Real-world clinical outcomes in Japanese patients with locally advanced squamous cell carcinoma of the head and neck treated with radiotherapy plus cetuximab: a prospective observational study (JROSG12-2). Int J Clin Oncol 2022; 27:1675-1683. [PMID: 36001247 DOI: 10.1007/s10147-022-02228-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/26/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Radiotherapy plus cetuximab (bioradiotherapy: BRT) is a standard option in the treatment of locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Published data on its safety and efficacy in real-world settings is limited. Here, we conducted a prospective multi-institutional observational study to evaluate clinical outcomes of BRT in patients with LA-SCCHN. METHODS We analyzed real-world data of all patients who underwent BRT from 2013 to 2016. The primary endpoint was 1-year progression-free survival (PFS). Secondary endpoints were 1-year locoregional PFS (LPFS), treatment completion rate (TCR), and adverse events (AEs). RESULTS A total of 171 patients with a minimum 1-year follow-up were analyzed. Median age was 67 (36-85) years, and 37 patients (21.6%) were aged 75 years or older. 1-year PFS and LPFS were 51.5 and 56.1%, respectively. N stage (p = 0.049) was significantly associated with PFS. TCR was 77.2%. Cetuximab was definitively discontinued in 30 patients (17.5%), in 15 cases due to severe mucositis. N stage, T stage, and comorbidity were significantly associated with TCR. Major AEs of grade 3 or higher were pharyngeal mucositis (48.5%), radiation dermatitis (45.6%), and oral mucositis (40.4%). Pneumonitis was observed in 12 patients (7.0%); 6 cases (3.5%) were grades 3-4 and 2 (1.2%) were grade 5. CONCLUSION As a result of the large number of elderly patients in clinical practice, toxicity reduced TCR. BRT-induced pneumonitis, which is sometimes fatal, was found to be more frequent than with chemotherapy plus cetuximab.
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Affiliation(s)
- Yosuke Ota
- Department of Radiation Oncology, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi City, Hyogo, 673-8558, Japan.
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hirofumi Fujii
- Department of Clinical Oncology, Jichi Medical University, Shimotsuke, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Tomoya Yokota
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto, Japan
| | - Torahiko Nakashima
- Department of Otolaryngology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Nobuya Monden
- Department of Head and Neck Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shinya Ueda
- Department of Gastroenterology-Medical Oncology, Iseikai Hospital, Osaka, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Long-term efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin and S-1 for head and neck squamous cell carcinoma. Auris Nasus Larynx 2019; 46:882-888. [DOI: 10.1016/j.anl.2018.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 12/15/2018] [Accepted: 12/26/2018] [Indexed: 11/23/2022]
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Safety and efficacy of concurrent carboplatin or cetuximab plus radiotherapy for locally advanced head and neck cancer patients ineligible for treatment with cisplatin. Int J Clin Oncol 2019; 24:468-475. [DOI: 10.1007/s10147-018-01392-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/29/2018] [Indexed: 11/26/2022]
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Namba C, Tohyama M, Murakami M, Yoshida T, Ugumori T, Hato N, Tano T, Hamakawa H, Kojima Y, Nishina T, Monden N, Fujita H, Sayama K. Relationships between cetuximab-induced anaphylaxis and specific antibodies against allergen and tick-transmitted infections. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2018. [DOI: 10.1002/cia2.12016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Chika Namba
- Department of Dermatology; Ehime University Graduate School of Medicine; Toon Japan
| | - Mikiko Tohyama
- Department of Dermatology; Ehime University Graduate School of Medicine; Toon Japan
| | - Masamoto Murakami
- Department of Dermatology; Ehime University Graduate School of Medicine; Toon Japan
| | - Tadashi Yoshida
- Department of Otorhinolaryngology, Head and Neck Surgery; Ehime University Graduate School of Medicine; Toon Japan
| | - Tohru Ugumori
- Department of Otorhinolaryngology, Head and Neck Surgery; Ehime University Graduate School of Medicine; Toon Japan
| | - Naohito Hato
- Department of Otorhinolaryngology, Head and Neck Surgery; Ehime University Graduate School of Medicine; Toon Japan
| | - Tomoyuki Tano
- Department of Oral and Maxillofacial Surgery; Ehime University Graduate School of Medicine; Toon Japan
| | - Hiroyuki Hamakawa
- Department of Oral and Maxillofacial Surgery; Ehime University Graduate School of Medicine; Toon Japan
| | - You Kojima
- Gastroenterology and Surgical Oncology; Ehime University Graduate School of Medicine; Toon Japan
| | - Tomohiro Nishina
- Department of Gastrointestinal Medical Oncology; National Shikoku Cancer Center; Matsuyama Japan
| | - Nobuya Monden
- Department of Head and Neck Medical Surgery; National Shikoku Cancer Center; Matsuyama Japan
| | | | - Koji Sayama
- Department of Dermatology; Ehime University Graduate School of Medicine; Toon Japan
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Koldenhof JJ, Langenberg MHG, Witteveen PO, Teunissen SCCM. Patient-reported symptoms and stepwise symptom management in patients on epidermal growth factor inhibitors: A retrospective, descriptive cohort study. Eur J Cancer Care (Engl) 2018; 27:e12800. [PMID: 29314360 DOI: 10.1111/ecc.12800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2017] [Indexed: 12/18/2022]
Abstract
Adverse events (AEs) of epidermal growth factor inhibitors (EGFRi) influence well-being with a risk to dose modifications (DMs). Hereby, clinical benefit of treatment might be affected. This retrospective cohort study was set up to gain insight into the suitability and added value of a patient-reported outcome measurement tool (PROM), together with a stepwise intervention management plan for EGFRi-related AEs in daily practice. The primary objective was to gain insight into total treatment duration and DMs, and the secondary objective to gain insight into patient-reported symptoms and well-being as well as healthcare professional-reported AEs. Sixty-eight patients on cetuximab and 19 on panitumumab treatment were included for analysis; 69% had squamous cell carcinoma of head and neck (SCCHN) and 26% metastatic colorectal carcinoma. DMs due to AEs occurred in 39% of the patients and dose discontinuations in 22%. Especially anorexia, dysphagia, oral pain and skin changes led to a decreased well-being. In patients on EGFRi, application of PROMs together with a stepwise symptom management plan enhances early recognition of symptom burden, pro-active symptom management and effect evaluation of interventions performed whereby well-being recovers. Since only SCCHN patients discontinued treatment due to AEs, patient-centred care focused on radiotherapy-related AEs, creates opportunities for amelioration.
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Affiliation(s)
- J J Koldenhof
- Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - M H G Langenberg
- Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - P O Witteveen
- Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - S C C M Teunissen
- Department of Primary Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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Bonomo P, Loi M, Desideri I, Olmetto E, Delli Paoli C, Terziani F, Greto D, Mangoni M, Scoccianti S, Simontacchi G, Francolini G, Meattini I, Caini S, Livi L. Incidence of skin toxicity in squamous cell carcinoma of the head and neck treated with radiotherapy and cetuximab: A systematic review. Crit Rev Oncol Hematol 2017; 120:98-110. [DOI: 10.1016/j.critrevonc.2017.10.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 09/28/2017] [Accepted: 10/29/2017] [Indexed: 12/27/2022] Open
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Rambeau A, Gervais R, De Raucourt D, Babin E, Dugué AE, Florescu C, Blanchard D, Gery B. Retrospective evaluation of concomitant cetuximab and radiotherapy tolerance for locoregional advanced head and neck squamous cell carcinoma treatment in patients unfit for platinum-based chemotherapy. Eur Arch Otorhinolaryngol 2017; 274:2883-2889. [DOI: 10.1007/s00405-017-4550-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
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Abstract
An increasing number of patients are diagnosed with esophageal cancer at an advanced stages, and only a small group of them can benefit from the traditional chemotherapy and radiotherapy. So far, multiple monoclonal antibodies and tyrosine kinase inhibitors have been developed, alone or in combination with traditional therapy, to improve the prognosis of patients with advanced esophageal cancer. This review summarizes the recent advances of targeted therapies against EGFR, HER2, VEGFR and c-MET in esophageal cancer. More clinical trials should be performed to evaluate the efficacy and safety of various targeted therapy regimens. Future basic research should focus on investigating the molecular mechanisms of therapeutic targets in esophageal cancer.
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Affiliation(s)
- Lei Zhang
- a Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China.,b Department of General Surgery , NO. 406 Hospital, Da Lian , China
| | - Jiaojiao Ma
- a Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Yu Han
- c Department of Otolaryngology , Xijing Hospital, Fourth Military Medical University , Xi'an , China
| | - Jinqiang Liu
- a Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Wei Zhou
- a Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Liu Hong
- a Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Daiming Fan
- a Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
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Ishimaru M, Ono S, Suzuki S, Matsui H, Fushimi K, Yasunaga H. Artificial nutrition dependence after cetuximab versus cisplatin combined with radiotherapy for advanced head and neck cancer: A propensity score-matched analysis. Head Neck 2016; 39:320-325. [PMID: 27635865 DOI: 10.1002/hed.24583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/13/2016] [Accepted: 08/05/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare the effect of cetuximab-based radiotherapy (RT) with cisplatin-based concomitant chemoradiotherapy (CCRT) on artificial nutrition dependence in locoregional advanced head and neck cancer. METHODS We identified patients treated with cetuximab-based RT or CCRT between 2012 and 2014 in a Japanese national database, and used propensity score-matched analyses to evaluate artificial nutrition dependence for 30 days after starting chemotherapy and at hospital discharge. RESULTS Of 3935 eligible patients, propensity score matching generated 250 pairs. Thirty-day artificial nutrition dependence was significantly lower in the cetuximab-based RT group than in the CCRT group (25.6% vs 35.2%; odds ratio [OR] = 0.67; 95% confidence interval [CI] = 0.46-0.97; p = .036). No significant difference in artificial nutrition dependence at hospital discharge was shown (6.2% vs 7.2%; OR = 1.07; 95% CI = 0.52-2.17; p = .861). Difference in duration of hospitalization was insignificant. CONCLUSION Cetuximab-based RT may reduce short-term artificial nutrition dependence compared to CCRT. © 2016 Wiley Periodicals, Inc. Head Neck 39: 320-325, 2017.
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Affiliation(s)
- Miho Ishimaru
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Sachiko Ono
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Sayaka Suzuki
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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