Phase II Trial of a Paclitaxel-Carboplatin Combination in Recurrent Squamous Cell Carcinoma of the Head and Neck

Abstract

Objective: Twenty-seven patients with recurrent squamous cell carcinoma of the head and neck were entered in a multicenter study to determine the efficacy of the paclitaxel-carboplatin association. Methods: Standard eligibility criteria applied, i.e. measurable disease, and chemotherapy given as induction treatment or concomitant chemoradiotherapy was allowed if completed more than 6 months prior to the study. Every 21 days, paclitaxel 175 mg/m² and carboplatin AUC 6 were administered. The patient group included 3 females and 24 males with a median age of 61 years (range 39–75 years). Results: All patients were assessable for toxicity and 24 for responses. Main grade 3–4 toxicities were: neutropenia (62.9%), febrile neutropenia (18.5%), anemia (11.1%), thrombocytopenia (14.8%), mucositis (7.4%) and vomiting (7.4%). Among the intent-to-treat population, 29.6% of patients had an objective response, with a median response duration of 4.2 months (range 1–5.7 months). Stable and progressive disease were observed in 11.1 and 48.1% of patients, respectively. The median overall survival was 7.2 months (range 0.5–10.9 months). Conclusion: From these data, paclitaxel-carboplatin seems to have an activity in recurrent squamous cell carcinoma of the head and neck, but the high level of toxicity highlights the need to search for a safer chemotherapy combination.

Weekly Paclitaxel and Carboplatin Combination Chemotherapy in Patients with Advanced Squamous Cell Carcinoma of the Head and Neck

“…71 mg/m 2 /week. This is some 10% above the DI planned by others [6,7,9,10] and considerably more than the 50 mg/m 2 /week applied by Fountzilas et al [8]. Therefore, it seems feasible to increase the DI by weekly administration of carboplatin and paclitaxel in patients with advanced SCCHN.…”

“…After encouraging results from Forastiere et al [4,5], taxanes were added to the platinum compounds in several studies. Combining carboplatin and paclitaxel achieved RR of 30-50% [6][7][8][9][10], and adding a third compound may enhance the RR to 65% [11,12]. However, considerable toxicity was encountered, also for the combination of cisplatin and low-or high-dose paclitaxel [13].…”

Pemetrexed Disodium: A Novel Antifolate Clinically Active Against Multiple Solid Tumors

“…Pivot et al [8] administered pemetrexed 500 mg/m 2 (without folic acid and vitamin B 12 supplementation) to patients with squamous cell carcinoma of the head and neck with a response rate of 33% and an equal percent achieving stable disease. Grade 3/4 hematological toxicities were neutropenia (43%) and anemia (12%).…”

Pravastatin Attenuates Carboplatin-Induced Nephrotoxicity in Rodents via Peroxisome Proliferator-Activated Receptor α-Regulated Heme Oxygenase-1

“…Carboplatin (cis-diammine-1,1-cyclobutane dicarboxylate platinum II), a second-generation platinum-containing anticancer drug, is currently used in the treatment of lung, ovarian, and head and neck cancers (Pivot et al, 2001;Fujiwara et al, 2003). Because carboplatin has fewer toxic effects than cisplatin, it can be used at higher doses to achieve optimal antitumor effects (for review, see Alberts, 1995).…”