I Pajares Bernad1, J Martínez Trufero2, L Calera Urquizu2, R A Pazo Cid2, A Cebollero de Miguel2, M J Agustin3, M Lanzuela4, A Antón2. 1. Medical Oncology Department, Miguel Servet University Hospital, 1-3 Isabel la Catolica Avenue, 50009, Saragossa, Spain. ispaber@hotmail.com. 2. Medical Oncology Department, Miguel Servet University Hospital, 1-3 Isabel la Catolica Avenue, 50009, Saragossa, Spain. 3. Pharmacy Department, Miguel Servet University Hospital, Saragossa, Spain. 4. Radiotherapy Department, Miguel Servet University Hospital, Saragossa, Spain.
Abstract
BACKGROUND: Standard treatment for recurrent/metastatic head and neck squamous cell carcinoma (RM-SCCHN) is based in on platinum and cetuximab combination therapy. Unfortunately, not all patients are candidates to receive platinum-based treatment, because of different conditions as comorbidity and poor performance status. Weekly paclitaxel and cetuximab (WPC) is an active therapeutic alternative, based on a phase II study, with less toxicity. Our main objective is to confirm its activity in unselected patients, mostly unfit for aggressive therapies, analysing also some clinically relevant prognostic factors (PFs). METHODS: Retrospective data was collected for RM-SCCHN patients, treated at our institution between January 2008 and July 2014 with weekly paclitaxel (80 mg/m2) and cetuximab (400/250 mg/m2). RESULTS: 148 patients were treated. The objective response rate (OR) was as follows: 13 patients (8.78%) complete response (CR); 57 patients (38.51%) partial response (PR) and 30 patients (20.3%) stable disease (SD). Median overall survival (OS) was 10 months (95% CI 8.31-11.69) and median progression free survival (PFS) was 7 months (95% CI 5.88-8.12). Response to treatment showed independent prognosis relevance as PF in multivariate analysis for PFS and OS. Furthermore, decline in serum magnesium during the treatment was also an independent PF for OS. CONCLUSIONS: WPC activity was confirmed as a useful therapy on real-life unselected RM-SCCHN patients, with similar benefit to that obtained in the phase II study, and comparable to platinum and cetuximab based treatment, confirming its value in unfit patients. In addition to treatment response, a change in serum magnesium values during treatment was proved as independent PF on OS.
BACKGROUND: Standard treatment for recurrent/metastatic head and neck squamous cell carcinoma (RM-SCCHN) is based in on platinum and cetuximab combination therapy. Unfortunately, not all patients are candidates to receive platinum-based treatment, because of different conditions as comorbidity and poor performance status. Weekly paclitaxel and cetuximab (WPC) is an active therapeutic alternative, based on a phase II study, with less toxicity. Our main objective is to confirm its activity in unselected patients, mostly unfit for aggressive therapies, analysing also some clinically relevant prognostic factors (PFs). METHODS: Retrospective data was collected for RM-SCCHN patients, treated at our institution between January 2008 and July 2014 with weekly paclitaxel (80 mg/m2) and cetuximab (400/250 mg/m2). RESULTS: 148 patients were treated. The objective response rate (OR) was as follows: 13 patients (8.78%) complete response (CR); 57 patients (38.51%) partial response (PR) and 30 patients (20.3%) stable disease (SD). Median overall survival (OS) was 10 months (95% CI 8.31-11.69) and median progression free survival (PFS) was 7 months (95% CI 5.88-8.12). Response to treatment showed independent prognosis relevance as PF in multivariate analysis for PFS and OS. Furthermore, decline in serum magnesium during the treatment was also an independent PF for OS. CONCLUSIONS: WPC activity was confirmed as a useful therapy on real-life unselected RM-SCCHN patients, with similar benefit to that obtained in the phase II study, and comparable to platinum and cetuximab based treatment, confirming its value in unfit patients. In addition to treatment response, a change in serum magnesium values during treatment was proved as independent PF on OS.
Entities:
Keywords:
Head and neck squamous cell carcinoma; Prognostic factors; Recurrent metastatic; Serum magnesium; Weekly paclitaxel cetuximab
Authors: Eric Winquist; Intisar Al-Rasheedy; Anthony C Nichols; David A Palma; Larry Stitt Journal: Cancer Treat Rev Date: 2014-08-27 Impact factor: 12.111
Authors: José Baselga; José M Trigo; Jean Bourhis; Jacques Tortochaux; Hernán Cortés-Funes; Ricardo Hitt; Pere Gascón; Nadia Amellal; Andreas Harstrick; André Eckardt Journal: J Clin Oncol Date: 2005-07-11 Impact factor: 44.544
Authors: Jacques Ferlay; Hai-Rim Shin; Freddie Bray; David Forman; Colin Mathers; Donald Maxwell Parkin Journal: Int J Cancer Date: 2010-12-15 Impact factor: 7.396
Authors: Paul M Weinberger; Ziwei Yu; Bruce G Haffty; Diane Kowalski; Malini Harigopal; Janet Brandsma; Clarence Sasaki; John Joe; Robert L Camp; David L Rimm; Amanda Psyrri Journal: J Clin Oncol Date: 2006-01-09 Impact factor: 44.544
Authors: Jan Bogaerts; Robert Ford; Dan Sargent; Lawrence H Schwartz; Larry Rubinstein; Denis Lacombe; Elizabeth Eisenhauer; Jaap Verweij; Patrick Therasse Journal: Eur J Cancer Date: 2008-12-16 Impact factor: 9.162
Authors: Aaron E Sosa; Juan J Grau; Luis Feliz; Verónica Pereira; Diego Alcaraz; Carmen Muñoz-García; Miguel Caballero Journal: Eur Arch Otorhinolaryngol Date: 2013-05-04 Impact factor: 2.503
Authors: Glaucia Maria de Mendonça Fernandes; Ana Lívia Silva Galbiatti-Dias; Leticia Antunes Muniz Ferreira; Vilson Serafim Junior; Gabriela Helena Rodrigues-Fleming; Juliana Garcia de Oliveira-Cucolo; Patrícia Matos Biselli-Chicote; Rosa Sayoko Kawasaki-Oyama; José Victor Maniglia; Érika Cristina Pavarino; Eny Maria Goloni-Bertollo Journal: Am J Transl Res Date: 2021-01-15 Impact factor: 4.060