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Oral Oncol. 2017 Jun;69:33-37. doi: 10.1016/j.oraloncology.2017.04.002. Epub 2017 Apr 9.

Outcome of recurrent and metastatic head and neck squamous cell cancer patients after first line platinum and cetuximab therapy.

Author information

1
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.
2
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.
3
Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Dept., Via Venezian 1, I-20133 Milan, Italy.
4
Fondazione IRCCS I.N.T., Clin. Epidemiology and Trials Org. Unit, I-20133 Milan, Italy.
5
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.

Abstract

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).

KEYWORDS:

Anti-EGFR; Chemotherapy; Head & neck cancer; Metastatic; Recurrent; Second line

[Indexed for MEDLINE]

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