Journal article
Outcome of recurrent and metastatic head and neck squamous cell cancer patients after first line platinum and cetuximab therapy.
- Siano M Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy; Cantonal Hospital St. Gallen, Dept. of Med. Oncology and Hematology, Rorschacherstrasse 95, CH-9007 St. Gallen, Switzerland. Electronic address: marco.siano@kssg.ch.
- Infante G Fondazione IRCCS I.N.T., Clin. Epidemiology and Trials Org. Unit, I-20133 Milan, Italy; Politecnic University Milan, Piazza Leonardo da Vinci, 32, I-20133 Milano, Italy.
- Resteghini C Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy.
- Cau MC Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy.
- Alfieri S Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy.
- Bergamini C Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy.
- Granata R Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy.
- Miceli R Fondazione IRCCS I.N.T., Clin. Epidemiology and Trials Org. Unit, I-20133 Milan, Italy.
- Locati L Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy.
- Licitra L Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy; State University of Milan, Via Festa del Perdono, 7, I-20122 Milano, Italy.
- Bossi P Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy.
- 2017-06-01
Published in:
- Oral oncology. - 2017
Anti-EGFR
Chemotherapy
Head & neck cancer
Metastatic
Recurrent
Second line
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
Carboplatin
Carcinoma, Squamous Cell
Cetuximab
Cisplatin
ErbB Receptors
Female
Head and Neck Neoplasms
Humans
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Recurrence, Local
Squamous Cell Carcinoma of Head and Neck
Survival Analysis
Treatment Outcome
English
OBJECTIVES
Second-line chemotherapy in recurrent and/or metastatic head and neck cancer (r/mHNSCC) patients showed dismal results with limited tumor response and reduced life expectancy. Outside of clinical trials, data on efficacy of second line treatment after first line anti-EGFR-AB combination therapy are not available.
MATERIAL AND METHODS
Data regarding r/mHNSCC consecutive pts treated with cetuximab and platinum from 2009 to 2014 at our center were retrospectively collected. The analyses of response, Progression-Free Survival (PFS) and Overall Survival (OS), each evaluated starting from first and second-line treatment, were performed. Survival curves were estimated with the Kaplan-Meier method and compared using the log-rank test.
RESULTS
We identified 117 patients treated with first-line platinum and cetuximab-based therapy. Sixty-four (55%) patients did not receive second-line treatment due to worsening in performance status, 2 were not assessable for response thus 51 patients were included for analysis. Fifty-six percent were smokers/former smokers and 78% were male. Primary tumor sites were oropharynx (39%), oral cavity (31%), larynx/hypopharynx (24%) and others (6%). Regimens used in second-line were mostly monotherapies. Twenty-one % of the patients were treated within a clinical trial. Response rate (PR, CR) was 6% with 45% showing SD as best response. Median PFS was 2.2months (95%CI:1.5-2.8months) and OS 6.1months (95%CI:3.7-7.2months).
CONCLUSIONS
Within our single center experience only half of the patients with r/mHNSCC were able to receive second-line treatment. Response rate was unsatisfactory, but median OS seems higher than previously reported in an anti-EGFR-AB naïve population (Leon 2005).
Second-line chemotherapy in recurrent and/or metastatic head and neck cancer (r/mHNSCC) patients showed dismal results with limited tumor response and reduced life expectancy. Outside of clinical trials, data on efficacy of second line treatment after first line anti-EGFR-AB combination therapy are not available.
MATERIAL AND METHODS
Data regarding r/mHNSCC consecutive pts treated with cetuximab and platinum from 2009 to 2014 at our center were retrospectively collected. The analyses of response, Progression-Free Survival (PFS) and Overall Survival (OS), each evaluated starting from first and second-line treatment, were performed. Survival curves were estimated with the Kaplan-Meier method and compared using the log-rank test.
RESULTS
We identified 117 patients treated with first-line platinum and cetuximab-based therapy. Sixty-four (55%) patients did not receive second-line treatment due to worsening in performance status, 2 were not assessable for response thus 51 patients were included for analysis. Fifty-six percent were smokers/former smokers and 78% were male. Primary tumor sites were oropharynx (39%), oral cavity (31%), larynx/hypopharynx (24%) and others (6%). Regimens used in second-line were mostly monotherapies. Twenty-one % of the patients were treated within a clinical trial. Response rate (PR, CR) was 6% with 45% showing SD as best response. Median PFS was 2.2months (95%CI:1.5-2.8months) and OS 6.1months (95%CI:3.7-7.2months).
CONCLUSIONS
Within our single center experience only half of the patients with r/mHNSCC were able to receive second-line treatment. Response rate was unsatisfactory, but median OS seems higher than previously reported in an anti-EGFR-AB naïve population (Leon 2005).
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.oraloncology.2017.04.002
- PMID 28559018
- Persistent URL
- https://sonar.ch/global/documents/186475
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