Weekly Docetaxel, Cisplatin, and Cetuximab in Palliative Treatment of Patients with Squamous Cell Carcinoma of the Head and Neck

Abstract

Lessons Learned. Chemotherapy for recurrent, metastatic squamous cell carcinoma of the head and neck need not be known for extreme toxicity.The weekly regimen studied here has been demonstrated to be tolerable and effective.Background.The objective of this study was to establish the response rate, progression‐free survival (PFS) and overall survival (OS), and safety profile of weekly docetaxel, platinum, and cetuximab (TPC) in patients with relapsed or metastatic squamous cell carcinoma of the head and neck (SCCHN).Materials and Methods.Twenty‐nine patients with metastatic or recurrent SCCHN with an Eastern Cooperative Oncology Group (ECOG) performance status <3 were enrolled in an institutional review board‐approved phase II trial. This study permitted prior chemoradiation, radiation, and/or surgery, provided that 3 months had elapsed since the end of the potentially curative treatment. Patients received cisplatin 30 mg/m2 or carboplatin area under the curve (AUC) 2, docetaxel 30 mg/m2, and cetuximab 250 mg/m2 weekly for 3 weeks, followed by a break during the fourth week, for a 28‐day cycle. Planned intrapatient dose modifications were based on individual toxicity.Results.Twenty‐seven patients received TPC and were evaluable for response and toxicity. Rates of complete response (CR), partial response (PR), and confirmed PR were 3%, 52%, and 30%, respectively. The overall objective response rate was 56%. Estimated median PFS and OS were 4.8 and 14.7 months, respectively. The rates of grade 3 and 4 worst‐grade adverse events (AEs) per patient were 85% and 7%, respectively. Dose density through cycle 4 was preserved for all patients; however, treatment beyond cycle 6 with the TPC regimen proved unfeasible.Conclusion.Weekly docetaxel, cisplatin, and cetuximab is an effective regimen for patients with metastatic or recurrent SCCHN. Response rates, PFS, and OS compare favorably with other combination chemotherapy treatments. Grade 4 toxicity rates observed in this study were substantially lower than those described with regimens using less frequent, higher‐dose chemotherapy schedules.

RETRACTED: Combination of Tanshinone IIA and Cisplatin Inhibits Esophageal Cancer by Downregulating NF-κB/COX-2/VEGF Pathway

“…The compound ID (CID) of DDP in PubChem Compound is 441203 ( Figure 1B ). It has been extensively utilized to cure different types of neoplasms, including head and neck ( 9 , 10 ), lung ( 11 , 12 ), ovarian ( 13 , 14 ), breast ( 15 , 16 ), brain ( 17 , 18 ), kidney ( 19 , 20 ), and esophagus cancers ( 21 – 23 ). In general, DDP and other platinum-based compounds are considered to be cytotoxic drugs, which can induce apoptosis of cancer cells ( 24 ).…”

Weekly chemotherapy as first line treatment in frail head and neck cancer patients in the immunotherapy era

“…In contrast to the PS 0–1 populations often included in randomized clinical trials, the EXTREME regimen is contraindicated in PS 2 patients, who often make up the majority of the patients seen in real-world clinical practice for the high risk of infectious diseases and high-grade toxicities. Therefore, cetuximab was evaluated in combination with different platinum-based regimens [ 15 , 16 ]. Several retrospective and prospective studies have examined first-line chemotherapy based on a weekly combination of paclitaxel and cetuximab in R/M-HNSCCs, showing promising activity [ 11 , 17 , 18 ].…”

Shooting at Moving and Hidden Targets—Tumour Cell Plasticity and the Notch Signalling Pathway in Head and Neck Squamous Cell Carcinomas

“…Nevertheless, the primary use of Cetuximab is currently still recommended, mainly for the palliative treatment of recurrent and metastatic HNSCC [ 135 , 136 ], or R/M HNSCC. Cetuximab was further introduced as part of the EXTREME treatment regimen, combined with cisplatin or carboplatin, and 5-FU [ 137 ].…”