Hiroki Sato1, Kiyoaki Tsukahara1, Isaku Okamoto1, Yasuaki Katsube1, Akira Shimizu1, Takahito Kondo2, Kenji Hanyu2, Chihiro Fushimi3, Takuro Okada3, Kouki Miura3. 1. a Department of Otorhinolaryngology, Head and Neck Surgery , Tokyo Medical University , Tokyo , Japan. 2. b Department of Otorhinolaryngology, Head and Neck Surgery , Tokyo Medical University Hachioji Medical Center , Tokyo , Japan. 3. c Department of Head and Neck Oncology and Surgery , International University of Health and Welfare Mita Hospital , Tokyo , Japan.
Abstract
BACKGROUND: Combination therapy consisting of a platinum agent, 5-fluorouracil and cetuximab (EXTREME regimen) is recommended for recurrent or metastatic squamous cell carcinoma of the head and neck (R/M-SCCHN). However, it is advisable to use platinum-free regimens as first-line therapy in patients resistant to platinum agents. There has been no report comparing EXTREME regimen outcomes between platinum-resistant and platinum-sensitive patients. OBJECTIVES: We conducted this study to examine the outcomes of the EXTREME regimen as first-line therapy in patients with R/M-SCCHN and a history of platinum agent use and assess whether the EXTREME regimen outcomes differ between platinum-resistant and platinum-sensitive patients. MATERIALS AND METHODS: The study included 32 patients with R/M-SCCHN who received the EXTREME regimen as first-line therapy. Patients with recurrence or metastasis within 6 months after cisplatin administration were considered platinum-resistant and those with no recurrence or metastasis within 6 months were considered platinum-sensitive. RESULTS: 17 patients were platinum-resistant and 15 patients were platinum-sensitive. The median survival durations were 10.6 and 19.9 months in the platinum-resistant and platinum-sensitive patients, respectively, and the prognosis was significantly better in the platinum-sensitive patients (p = .02). CONCLUSIONS: Our findings suggest that the EXTREME regimen is useful as first-line therapy for R/M-SCCHN in platinum-sensitive patients.
BACKGROUND: Combination therapy consisting of a platinum agent, 5-fluorouracil and cetuximab (EXTREME regimen) is recommended for recurrent or metastatic squamous cell carcinoma of the head and neck (R/M-SCCHN). However, it is advisable to use platinum-free regimens as first-line therapy in patients resistant to platinum agents. There has been no report comparing EXTREME regimen outcomes between platinum-resistant and platinum-sensitive patients. OBJECTIVES: We conducted this study to examine the outcomes of the EXTREME regimen as first-line therapy in patients with R/M-SCCHN and a history of platinum agent use and assess whether the EXTREME regimen outcomes differ between platinum-resistant and platinum-sensitive patients. MATERIALS AND METHODS: The study included 32 patients with R/M-SCCHN who received the EXTREME regimen as first-line therapy. Patients with recurrence or metastasis within 6 months after cisplatin administration were considered platinum-resistant and those with no recurrence or metastasis within 6 months were considered platinum-sensitive. RESULTS: 17 patients were platinum-resistant and 15 patients were platinum-sensitive. The median survival durations were 10.6 and 19.9 months in the platinum-resistant and platinum-sensitive patients, respectively, and the prognosis was significantly better in the platinum-sensitive patients (p = .02). CONCLUSIONS: Our findings suggest that the EXTREME regimen is useful as first-line therapy for R/M-SCCHN in platinum-sensitive patients.
Entities:
Keywords:
Cetuximab; chemotherapy; head and neck; platinum-resistant; platinum-sensitive; squamous cell carcinoma