Efficacy and toxicity of weekly paclitaxel, carboplatin, and cetuximab as induction chemotherapy or in cases of metastases or relapse for head and neck cancer with a focus on elderly or frail patients.

BACKGROUND: Paclitaxel, carboplatin, and cetuximab (PCC) has shown promise as induction chemotherapy and in patients with metastatic/recurrent head and neck cancer (HNC). Given its tolerability, the regimen is used in frail and elderly patients.
METHODS: Software generated the cohort of adult patients with HNC treated with PCC in 2014-2019. Modified RECIST response rate (RR), progression-free survival (PFS), and overall survival (OS) were calculated for the metastatic/recurrent group, and successful induction rate and RR for the induction group. These were also calculated in the elderly/frail subset (EF): age ≥75, performance status ≥2, albumin <3.5.
RESULTS: Fifty-two percent of patients experienced ≥grade 3 toxicities. For metastatic/recurrent disease (N = 58), RR was 22%, mean PFS was 7.1 months. Mean OS was 15.2 months. In the induction cohort (N = 22), 86% reached their endpoint. The RR was 64%. There were no significant differences for EF.
CONCLUSIONS: PCC is well-tolerated with good induction success rate and reasonable PFS/OS in metastatic/recurrent disease.