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Induction chemotherapy in head and neck cancers: Results and controversies. Oral Oncol 2019; 95:164-169. [DOI: 10.1016/j.oraloncology.2019.06.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/07/2019] [Indexed: 11/20/2022]
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Chibaudel B, Lacave R, Lefevre M, Soussan P, Antoine M, Périé S, Belloc JB, Banal A, Albert S, Chabolle F, Céruse P, Baril P, Gatineau M, Housset M, Moukoko R, Benetkiewicz M, de Gramont A, Bonnetain F, Lacau St Guily J. Induction therapy with cetuximab plus docetaxel, cisplatin, and 5-fluorouracil (ETPF) in patients with resectable nonmetastatic stage III or IV squamous cell carcinoma of the oropharynx. A GERCOR phase II ECHO-07 study. Cancer Med 2015; 4:721-31. [PMID: 25684313 PMCID: PMC4430265 DOI: 10.1002/cam4.408] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/19/2014] [Accepted: 12/10/2014] [Indexed: 01/22/2023] Open
Abstract
Induction TPF regimen is a standard treatment option for squamous cell carcinoma (SCC) of the oropharynx. The efficacy and safety of adding cetuximab to induction TPF (ETPF) therapy was evaluated. Patients with nonmetastatic resectable stage III/IV SCC of the oropharynx were treated with weekly cetuximab followed the same day by docetaxel and cisplatin and by a continuous infusion of 5-fluorouracil on days 1-5 (every 3 weeks, 3 cycles). The primary endpoint was clinical and radiological complete response (crCR) of primary tumor at 3 onths. Secondary endpoints were crCR rates, overall response, pathological CR, progression-free survival, overall survival, and safety. Forty-two patients were enrolled, and 41 received ETPF. The all nine planned cetuximab doses and the full three doses of planned chemotherapy were completed in 31 (76%) and 36 (88%) patients, respectively. Twelve (29%) patients required dose reduction. The crCR of primary tumor at the completion of therapy was observed in nine (22%) patients. ETPF was associated with a tumor objective response rate (ORR) of 58%. The most frequent grade 3-4 toxicities were as follows: nonfebrile neutropenia (39%), febrile neutropenia (19%), diarrhea (10%), and stomatitis (12%). Eighteen (44%) patients experienced acne-like skin reactions of any grade. One toxic death occurred secondary to chemotherapy-induced colitis with colonic perforation. This phase II study reports an interesting response rate for ETPF in patients with moderately advanced SCC of the oropharynx. The schedule of ETPF evaluated in this study cannot be recommended at this dosage.
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Affiliation(s)
- Benoist Chibaudel
- Division of Medical Oncology, Franco-British Hospital InstituteLevallois-Perret, France
- GERCOR (Cooperator Multidisciplinary Oncology Group)Paris, France
- GERCOR-IRC (GERCOR-Innovative Research Consortium)Paris, France
| | - Roger Lacave
- Department of Histology and Tumor Biology, Hospital TenonParis, France
- ER2 Division, University Pierre et Marie CurieParis, France
- Clinical Research Group (GRC), Hospital TenonParis, France
| | - Marine Lefevre
- Division of Anatomic Pathology, Hospital TenonParis, France
| | | | | | - Sophie Périé
- Department of Otorhinolaryngology-Cervicofacial Surgery, Hospital TenonParis, France
| | - Jean-Baptiste Belloc
- Department of Otorhinolaryngology-Maxillofacial Surgery, Hospital Simone VeilMontmorency, France
| | - Alain Banal
- Department of Otorhinolaryngology-Head and Neck Surgery, Centre René HugueninSaint-Cloud, France
| | - Sébastien Albert
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Bichat-Claude BernardParis, France
| | - Frédéric Chabolle
- Department of Otolaryngology and Cervicofacial Surgery, Hospital FochSuresnes, France
| | - Philippe Céruse
- Department of Otorhinolaryngology-Cervicofacial Surgery, Hospital center Lyon-SudLyon, France
| | - Philippe Baril
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital DelafontaineSaint-Denis, France
| | - Michel Gatineau
- Medical Oncology Service, Groupe Hospitalier Saint JosephParis, France
| | - Martin Housset
- Department of Radiation Oncology, Georges Pompidou European HospitalParis, France
| | - Rachel Moukoko
- GERCOR (Cooperator Multidisciplinary Oncology Group)Paris, France
| | | | - Aimery de Gramont
- Division of Medical Oncology, Franco-British Hospital InstituteLevallois-Perret, France
- GERCOR (Cooperator Multidisciplinary Oncology Group)Paris, France
- GERCOR-IRC (GERCOR-Innovative Research Consortium)Paris, France
| | - Franck Bonnetain
- Methodological and Quality of Life in Oncology Unit (EA3181) & Quality of Life and Cancer Clinical Research Platform, Besançon University HospitalBesançon, France
| | - Jean Lacau St Guily
- ER2 Division, University Pierre et Marie CurieParis, France
- Clinical Research Group (GRC), Hospital TenonParis, France
- Department of Otorhinolaryngology-Cervicofacial Surgery, Hospital TenonParis, France
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Lang J, Gao L, Guo Y, Zhao C, Zhang C. Comprehensive treatment of squamous cell cancer of head and neck: Chinese expert consensus 2013. Future Oncol 2014; 10:1635-48. [PMID: 24635574 DOI: 10.2217/fon.14.44] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Abstract: Head and neck cancer is the sixth most common malignant tumor worldwide, and squamous cell cancer of the head and neck accounts for more than 90% of head and neck cancers. In China, the incidence of oral cavity and pharyngolaryngeal cancer is 3.28 per 100,000 with a mortality of 1.37 per 100,000, and the incidence of nasopharyngeal cancer is 3.61 per 100,000 with a mortality was 1.99 per 100,000. In 2013, an expert consensus conference was held in China with the aim of establishing the optimum multimodality treatments that are applied in Chinese patients with squamous cell cancer of the head and neck. The experts, who met to review the literature and discuss and modify treatment strategies used in clinical practice in China, reached a consensus on the optimum therapy approaches, which, in general, combine surgery, radiotherapy, chemotherapy and targeted therapy. The experts strongly recommended that healthcare providers should integrate proper medical resources into a collaborative group involving specialists in several disciplines to agree upon and provide the most effective therapy for individual patients.
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Affiliation(s)
- Jinyi Lang
- Radiotherapy Department, Sichuan Cancer Hospital & Institute, South Road of Renmin Street, 4th District, No. 55, Chengdu, 610041, People’s Republic of China
| | - Li Gao
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Ye Guo
- Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 20003, People’s Republic of China
| | - Chong Zhao
- Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Dong Road, Guangzhou, 510060, People’s Republic of China
| | - Chenping Zhang
- Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, ZhiZaoju Road, No. 639, Shanghai, 200011, People’s Republic of China
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Argiris A. Current status and future directions in induction chemotherapy for head and neck cancer. Crit Rev Oncol Hematol 2013; 88:57-74. [DOI: 10.1016/j.critrevonc.2013.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 01/22/2013] [Accepted: 03/05/2013] [Indexed: 02/06/2023] Open
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Specenier P, Vermorken JB. Cetuximab in the treatment of squamous cell carcinoma of the head and neck. Expert Rev Anticancer Ther 2011; 11:511-24. [PMID: 21504318 DOI: 10.1586/era.11.20] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The majority of the head and neck cancers are squamous cell carcinomas, which commonly overexpress the EGF receptor (EGFR). Cetuximab is a chimeric monoclonal antibody that binds with high affinity to the extracellular domain of EGFR, and in addition induces antibody-dependent cellular cytoxicity. In a randomized Phase III trial in patients with locoregionally advanced squamous cell carcinoma of the head and neck, the addition of cetuximab to radiotherapy prolonged the median time of locoregional control from 14.9 to 24.4 months and increased the median overall survival from 29.3 to 49.0 months. In patients with platinum-refractory recurrent and/or metastatic disease, the objective response and disease-control rates in various studies ranged from 10 to 13% and from 46 to 56%, respectively. In the EXTREME trial, the addition of cetuximab to platinum/5-fluorouracil as first-line treatment of recurrent/metastatic squamous cell carcinoma of the head and neck not only led to significant improvements in survival, response rate and disease control, but also induced a better symptom control in comparison with that observed with platinum/5-fluorouracil alone.
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Affiliation(s)
- Pol Specenier
- Department of Oncology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
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Molecular-targeted therapy of head and neck squamous cell carcinoma: beyond cetuximab-based therapy. Curr Opin Oncol 2011; 23:241-8. [DOI: 10.1097/cco.0b013e328344f581] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Argiris A, Heron DE, Smith RP, Kim S, Gibson MK, Lai SY, Branstetter BF, Posluszny DM, Wang L, Seethala RR, Dacic S, Gooding W, Grandis JR, Johnson JT, Ferris RL. Induction docetaxel, cisplatin, and cetuximab followed by concurrent radiotherapy, cisplatin, and cetuximab and maintenance cetuximab in patients with locally advanced head and neck cancer. J Clin Oncol 2010; 28:5294-300. [PMID: 21079141 DOI: 10.1200/jco.2010.30.6423] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
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/m2 day 1, cisplatin 75 mg/m2 day 1, and cetuximab 250 mg/m2 days 1, 8, and 15 (after an initial loading dose of 400 mg/m2), termed TPE, repeated every 21 days for three cycles, followed by radiotherapy with concurrent cisplatin 30 mg/m2 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.
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Affiliation(s)
- Athanassios Argiris
- University of Pittsburgh Medical Center Cancer Pavilion, 5th Floor, Pittsburgh, PA 15232, USA.
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Bourhis J, Lefebvre JL, Vermorken JB. Cetuximab in the management of locoregionally advanced head and neck cancer: expanding the treatment options? Eur J Cancer 2010; 46:1979-89. [PMID: 20561781 DOI: 10.1016/j.ejca.2010.05.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 05/06/2010] [Accepted: 05/10/2010] [Indexed: 11/30/2022]
Abstract
The treatment of locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN) has evolved in recent years as a consequence of a better understanding of the potential benefits associated with altered radiation fractionation regimens, concurrently administered chemotherapy and radiotherapy (chemoradiotherapy) and induction chemotherapy. Concurrent chemoradiotherapy is a treatment option for technically resectable disease, where functional morbidity precludes the use of surgery. Induction chemotherapy followed by radiotherapy may also be used in this setting, and has been validated for larynx preservation. Concurrent chemoradiotherapy is a standard treatment approach for medically fit patients with locoregionally advanced unresectable disease. However, the toxicity burden of additional chemotherapy in both the concurrent chemoradiotherapy and induction chemotherapy settings can have implications for treatment compliance and may impede the administration of chemotherapy and/or radiotherapy to schedule. The epidermal growth factor receptor (EGFR)-targeted IgG1 monoclonal antibody, cetuximab (Erbitux), has shown significant clinical benefits in the treatment of both locoregionally advanced and recurrent and/or metastatic SCCHN. A phase III study in locoregionally advanced disease demonstrated significant improvements in locoregional control and progression-free and overall survival with cetuximab plus radiotherapy compared with radiotherapy alone, and overall survival benefits were maintained at 5 years. The addition of cetuximab to concurrent chemoradiotherapy has been shown to be feasible in phase II trials and is being investigated in phase III trials. Preliminary evidence suggests that cetuximab could be incorporated into induction management strategies. Taken together, these data support an important role for cetuximab in the treatment paradigm for locoregionally advanced SCCHN.
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Affiliation(s)
- Jean Bourhis
- Institut Gustave Roussy, 39 rue Camille Desmoulins, Villejuif 94805, France
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Molecular targeted therapies in all histologies of head and neck cancers: an update. Curr Opin Oncol 2010; 22:212-20. [DOI: 10.1097/cco.0b013e328338001f] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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