Nab-Paclitaxel, Cisplatin, and 5-fluorouracil Followed by Concurrent Cisplatin and Radiation for Head and Neck Squamous Cell Carcinoma

Overview

Journal Oral Oncol

Publisher Elsevier

Specialty Dentistry

Date 2016 Oct 1

PMID 27688097

Citations 9

Authors

Douglas Adkins

Jessica Ley

Loren Michel

Tanya M Wildes

Wade Thorstad

Hiram A Gay

Mackenzie Daly

Jason Rich

Randal Paniello

Ravindra Uppaluri

Ryan Jackson

Kathryn Trinkaus

Brian Nussenbaum

Affiliations

Soon will be listed here.

Abstract

Objectives: We previously reported the efficacy of nab-paclitaxel added to cisplatin, 5-FU, and cetuximab (APF-C) followed by concurrent high dose bolus cisplatin and radiation therapy (CRT) in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). In this phase II trial, we determined the efficacy of APF (without cetuximab) followed by CRT in similar patients.

Materials And Methods: Eligible patients had stage III-IV oropharynx (OP), larynx, or hypopharynx SCC and adequate organ function and performance status. T1 tumors were excluded. Patients were treated with three cycles of APF followed by CRT. Efficacy endpoints included two-year disease-specific survival (DSS), progression-free survival (PFS), overall survival (OS), and relapse rate.

Results: Thirty patients were enrolled. Most patients were smokers (77%) with bulky T3/4 (73%) and N2/3 (83%) tumors. Analyses were stratified for human papilloma virus (HPV) status: HPV-related OPSCC (n=17; 57%) and HPV-unrelated HNSCC (n=13; 43%). With a minimum follow-up of 21months, relapse occurred in 1 (3%) patient. Two-year DSS was 94% in HPV-related OPSCC and 100% in HPV-unrelated HNSCC. Two-year PFS was 94% in HPV-related OPSCC and 100% in HPV-unrelated HNSCC. Two-year OS was 94% in HPV-related OPSCC and 92% in HPV-unrelated HNSCC. Causes of death were relapse (1), treatment-related mortality (1), and co-morbidity (1). Two patients with HPV-unrelated HNSCC treated with APF declined CRT and remained free of relapse at 36 and 28months of follow-up.

Conclusion: This phase II trial demonstrated favorable two-year DSS, PFS, and OS and a low relapse rate in HPV-unrelated HNSCC and HPV-related OPSCC treated with APF followed by CRT.

Citing Articles

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A systematic literature review of the human papillomavirus prevalence in locally and regionally advanced and recurrent/metastatic head and neck cancers through the last decade: The "ALARM" study.

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Chen J, Fang J, Zhong Q, Feng L, He S, Ma H Front Oncol. 2022; 12:857445.

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Insights into Nanomedicine for Immunotherapeutics in Squamous Cell Carcinoma of the head and neck.

Xu Q, Fang M, Zhu J, Dong H, Cao J, Yan L Int J Biol Sci. 2020; 16(14):2506-2517.

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The Slippery Role of Induction Chemotherapy in Head and Neck Cancer: Myth and Reality.

Ferrari D, Ghi M, Franzese C, Codeca C, Gau M, Fayette J Front Oncol. 2020; 10:7.

PMID: 32038985 PMC: 6989487. DOI: 10.3389/fonc.2020.00007.

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