Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy

Objectives: Induction chemotherapy (ICT) followed by definitive treatment is an accepted non-surgical approach for locoregionally advanced head and neck squamous cell carcinoma (LA-HNSCC). However, ICT remains a challenge for cisplatin-unfit patients. We evaluated paclitaxel and cetuximab (P-C) as I...

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Authors: Marín-Jiménez, Juan A, Oliva, Marc, Peinado Martín, Paloma, Cabezas-Camarero, Santiago, Plana Serrahima, Maria, Vázquez Masedo, Manuel Gonzalo, Lozano Borbalas, Alicia, Cabrera Martín, María Nieves, Esteve, Anna, Iglesias Moreno, María Cruz, Vilajosana Altamis, Esther, Arribas Hortigüela, Lorena, Taberna Sanz, Miren, Pérez Segura, Pedro, Mesía, Ricard
Format: article
Publication Date:2022
Country:España
Institution:Universidad Complutense de Madrid (UCM)
Repository:Docta Complutense
Language:English
OAI Identifier:oai:docta.ucm.es:20.500.14352/115270
Online Access:https://hdl.handle.net/20.500.14352/115270
Access Level:Open access
Keyword:616-006-089.5
Head and neck squamous cell carcinoma
Cetuximab
Cisplatin
Head and neck cancer
Induction chemotherapy
Paclitaxel
Radiotherapy
Unfit patient
Otorrinolaringología
Oncología
3207.13 Oncología
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oai_identifier_str oai:docta.ucm.es:20.500.14352/115270
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spelling Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based ChemotherapyMarín-Jiménez, Juan AOliva, MarcPeinado Martín, PalomaCabezas-Camarero, SantiagoPlana Serrahima, MariaVázquez Masedo, Manuel GonzaloLozano Borbalas, AliciaCabrera Martín, María NievesEsteve, AnnaIglesias Moreno, María CruzVilajosana Altamis, EstherArribas Hortigüela, LorenaTaberna Sanz, MirenPérez Segura, PedroMesía, Ricard616-006-089.5Head and neck squamous cell carcinomaCetuximabCisplatinHead and neck cancerInduction chemotherapyPaclitaxelRadiotherapyUnfit patientOtorrinolaringologíaOncología3207.13 OncologíaObjectives: Induction chemotherapy (ICT) followed by definitive treatment is an accepted non-surgical approach for locoregionally advanced head and neck squamous cell carcinoma (LA-HNSCC). However, ICT remains a challenge for cisplatin-unfit patients. We evaluated paclitaxel and cetuximab (P-C) as ICT in a cohort of LA-HNSCC patients unfit for cisplatin. Materials and methods: This is a retrospective analysis of patients with newly diagnosed LA-HNSCC considered unfit for cisplatin-based chemotherapy (age >70 and/or ECOG≥2 and/or comorbidities) treated with weekly P-C followed by definitive radiotherapy and cetuximab (RT-C) between 2010 and 2017. Toxicity and objective response rate (ORR) to ICT and RT-C were collected. Median overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method. Cox regression analysis was performed to determine baseline predictors of OS and PFS. Results: A total of 57 patients were included. Grade 3-4 toxicity rate to ICT was 54.4%, and there was a death deemed treatment-related (G5). P-C achieved an ORR of 66.7%, including 12.3% of complete responses (CR). After P-C, 45 patients (78.9%) continued with concomitant RT-C. Twenty-six patients (45.6%) achieved a CR after definitive treatment. With a median follow-up of 21.7 months (range 1.2-94.6), median OS and PFS were 22.9 months and 10.7 months, respectively. The estimated 2-year OS and PFS rates were 48.9% and 33.7%, respectively. Disease stage had a negative impact on OS (stage IVb vs. III-IVa: HR = 2.55 [1.08-6.04], p = 0.03), with a trend towards worse PFS (HR = 1.92 [0.91-4.05], p = 0.09). Primary tumor in the larynx was associated with improved PFS but not OS (HR = 0.45 [0.22-0.92], p = 0.03, and HR = 0.69 [0.32-1.54], p = 0.37, respectively). Conclusion: P-C was a well-tolerated and active ICT regimen in this cohort of LA-HNSCC patients unfit for cisplatin-based chemotherapy. P-C might represent a valid ICT option for unfit patients and may aid patient selection for definitive treatment.Frontiers Research FoundationUniversidad Complutense de Madrid20222022-07-0120222022-07-01journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/115270reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/1152702026-06-02T12:44:21Z
dc.title.none.fl_str_mv Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
title Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
spellingShingle Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
Marín-Jiménez, Juan A
616-006-089.5
Head and neck squamous cell carcinoma
Cetuximab
Cisplatin
Head and neck cancer
Induction chemotherapy
Paclitaxel
Radiotherapy
Unfit patient
Otorrinolaringología
Oncología
3207.13 Oncología
title_short Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
title_full Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
title_fullStr Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
title_full_unstemmed Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
title_sort Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
dc.creator.none.fl_str_mv Marín-Jiménez, Juan A
Oliva, Marc
Peinado Martín, Paloma
Cabezas-Camarero, Santiago
Plana Serrahima, Maria
Vázquez Masedo, Manuel Gonzalo
Lozano Borbalas, Alicia
Cabrera Martín, María Nieves
Esteve, Anna
Iglesias Moreno, María Cruz
Vilajosana Altamis, Esther
Arribas Hortigüela, Lorena
Taberna Sanz, Miren
Pérez Segura, Pedro
Mesía, Ricard
author Marín-Jiménez, Juan A
author_facet Marín-Jiménez, Juan A
Oliva, Marc
Peinado Martín, Paloma
Cabezas-Camarero, Santiago
Plana Serrahima, Maria
Vázquez Masedo, Manuel Gonzalo
Lozano Borbalas, Alicia
Cabrera Martín, María Nieves
Esteve, Anna
Iglesias Moreno, María Cruz
Vilajosana Altamis, Esther
Arribas Hortigüela, Lorena
Taberna Sanz, Miren
Pérez Segura, Pedro
Mesía, Ricard
author_role author
author2 Oliva, Marc
Peinado Martín, Paloma
Cabezas-Camarero, Santiago
Plana Serrahima, Maria
Vázquez Masedo, Manuel Gonzalo
Lozano Borbalas, Alicia
Cabrera Martín, María Nieves
Esteve, Anna
Iglesias Moreno, María Cruz
Vilajosana Altamis, Esther
Arribas Hortigüela, Lorena
Taberna Sanz, Miren
Pérez Segura, Pedro
Mesía, Ricard
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 616-006-089.5
Head and neck squamous cell carcinoma
Cetuximab
Cisplatin
Head and neck cancer
Induction chemotherapy
Paclitaxel
Radiotherapy
Unfit patient
Otorrinolaringología
Oncología
3207.13 Oncología
topic 616-006-089.5
Head and neck squamous cell carcinoma
Cetuximab
Cisplatin
Head and neck cancer
Induction chemotherapy
Paclitaxel
Radiotherapy
Unfit patient
Otorrinolaringología
Oncología
3207.13 Oncología
description Objectives: Induction chemotherapy (ICT) followed by definitive treatment is an accepted non-surgical approach for locoregionally advanced head and neck squamous cell carcinoma (LA-HNSCC). However, ICT remains a challenge for cisplatin-unfit patients. We evaluated paclitaxel and cetuximab (P-C) as ICT in a cohort of LA-HNSCC patients unfit for cisplatin. Materials and methods: This is a retrospective analysis of patients with newly diagnosed LA-HNSCC considered unfit for cisplatin-based chemotherapy (age >70 and/or ECOG≥2 and/or comorbidities) treated with weekly P-C followed by definitive radiotherapy and cetuximab (RT-C) between 2010 and 2017. Toxicity and objective response rate (ORR) to ICT and RT-C were collected. Median overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method. Cox regression analysis was performed to determine baseline predictors of OS and PFS. Results: A total of 57 patients were included. Grade 3-4 toxicity rate to ICT was 54.4%, and there was a death deemed treatment-related (G5). P-C achieved an ORR of 66.7%, including 12.3% of complete responses (CR). After P-C, 45 patients (78.9%) continued with concomitant RT-C. Twenty-six patients (45.6%) achieved a CR after definitive treatment. With a median follow-up of 21.7 months (range 1.2-94.6), median OS and PFS were 22.9 months and 10.7 months, respectively. The estimated 2-year OS and PFS rates were 48.9% and 33.7%, respectively. Disease stage had a negative impact on OS (stage IVb vs. III-IVa: HR = 2.55 [1.08-6.04], p = 0.03), with a trend towards worse PFS (HR = 1.92 [0.91-4.05], p = 0.09). Primary tumor in the larynx was associated with improved PFS but not OS (HR = 0.45 [0.22-0.92], p = 0.03, and HR = 0.69 [0.32-1.54], p = 0.37, respectively). Conclusion: P-C was a well-tolerated and active ICT regimen in this cohort of LA-HNSCC patients unfit for cisplatin-based chemotherapy. P-C might represent a valid ICT option for unfit patients and may aid patient selection for definitive treatment.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-07-01
2022
2022-07-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/115270
url https://hdl.handle.net/20.500.14352/115270
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Frontiers Research Foundation
publisher.none.fl_str_mv Frontiers Research Foundation
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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