Induction chemotherapy with paclitaxel, carboplatin and cetuximab for locoregionally advanced nasopharyngeal carcinoma: A single-center, retrospective study

Abstract

BackgroundThe addition of induction chemotherapy (IC) before chemoradiotherapy (CRT) has improved survival over CRT alone in locoregionally advanced nasopharyngeal cancer (LA-NPC). Nevertheless, this population would benefit from further development of a novel IC regimen with satisfactory efficacy and a more favorable safety profile.MethodsWe retrospectively assessed 29 LA-NPC patients who received the combination of paclitaxel (PTX), carboplatin (CBDCA), and cetuximab (Cmab) (PCE) as IC (IC-PCE) at the National Cancer Center Hospital East between March 2017 and April 2021. IC-PCE consisted of CBDCA area under the plasma concentration-time curve (AUC) = 1.5, PTX 80 mg/m2, and Cmab with an initial dose of 400 mg/m2 followed by 250 mg/m2 administered weekly for a maximum of eight weeks.ResultsPatient characteristics were as follows: median age, 59 years (range 24–75); 0, 1 performance status (PS), 25, 4 patients; and clinical stage III/IVA/IVB, 6/10/13. The median number of PCE cycles was 8(1-8). After IC-PCE, 26 patients received concurrent cisplatin and radiotherapy (CDDP-RT), one received concurrent carboplatin/5-fluorouracil and radiotherapy (CBDCA/5-FU-RT), and two received RT alone. The % completion of CDDP-RT was 88.5%. The response rate was 75.9% by IC and 100% at completion of CRT. The 3-year recurrence-free survival, locoregional failure-free survival, distant recurrence-free survival, and overall survival were 75.9%, 79.3%, 84.3%, and 96.3%, respectively. The incidence of adverse events of grade 3/4 was 34.5% during IC and 44.8% during CRT.ConclusionIC-PCE is feasible and effective for LA-NPC and may be a treatment option for this disease.

Efficacy and tolerability of a low dose weekly paclitaxel, carboplatin and cetuximab (PCC) regimen for metastatic or unresectable head and neck squamous cell carcinomas

“…Our study is novel in that it assesses low‐dose PCC. Owing to its different mechanism of action, toxicity profile and radio‐sensitising activity, low‐dose PCC may be more tolerable for patients with suboptimal performance status 6–8 …”

“…Owing to its different mechanism of action, toxicity profile and radio-sensitising activity, low-dose PCC may be more tolerable for patients with suboptimal performance status. [6][7][8] The objective of our study is thus to evaluate the tolerability and efficacy of low-dose PCC, which could be an attractive treatment option for metastatic or unresectable HNSCC patients who are not candidates for checkpoint inhibitors, 5-FU and/or high-dose chemotherapy regimens.…”