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Marín-Jiménez JA, Oliva M, Peinado Martín P, Cabezas-Camarero S, Plana Serrahima M, Vázquez Masedo G, Lozano Borbalas A, Cabrera Martín MN, Esteve A, Iglesias Moreno MC, Vilajosana Altamis E, Arribas Hortigüela L, Taberna Sanz M, Pérez-Segura P, Mesía R. Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy. Front Oncol 2022; 12:953020. [PMID: 35936723 PMCID: PMC9355730 DOI: 10.3389/fonc.2022.953020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Juan A. Marín-Jiménez
- Head and Neck Cancer Unit, Department of Medical Oncology, Catalan Institute of Oncology (ICO – L’Hospitalet de Llobregat), Barcelona, Spain
| | - Marc Oliva
- Head and Neck Cancer Unit, Department of Medical Oncology, Catalan Institute of Oncology (ICO – L’Hospitalet de Llobregat), Barcelona, Spain
- Oncobell Program - Bellvitge Biomedical Research Institute (Institut d'Investigació Biomèdica de Bellvitge), Barcelona, Spain
- *Correspondence: Marc Oliva, ; Ricard Mesía,
| | - Paloma Peinado Martín
- Head and Neck Cancer Unit, Department of Medical Oncology, Hospital Universitario Clínico San Carlos - Instituto de Investigación Sanitaria Hospital Clínica San Carlos, Madrid, Spain
| | - Santiago Cabezas-Camarero
- Head and Neck Cancer Unit, Department of Medical Oncology, Hospital Universitario Clínico San Carlos - Instituto de Investigación Sanitaria Hospital Clínica San Carlos, Madrid, Spain
| | - Maria Plana Serrahima
- Head and Neck Cancer Unit, Department of Medical Oncology, Catalan Institute of Oncology (ICO – L’Hospitalet de Llobregat), Barcelona, Spain
| | - Gonzalo Vázquez Masedo
- Department of Radiation Oncology, Hospital Universitario Clínico San Carlos - Instituto de Investigación Sanitaria Hospital Clínica San Carlos (IdISCC), Madrid, Spain
| | - Alicia Lozano Borbalas
- Department of Radiation Oncology, Catalan Institute of Oncology (ICO – L’Hospitalet de Llobregat), Barcelona, Spain
| | - María N. Cabrera Martín
- Department of Nuclear Medicine, Hospital Universitario Clínico San Carlos - IdISCC, Madrid, Spain
| | - Anna Esteve
- Department of Medical Oncology, Catalan Institute of Oncology (ICO-Badalona), B-ARGO group, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Barcelona, Spain
- Oncology Data Analytics Program, Catalan Institute of Oncology (ICO – L’Hospitalet de Llobregat) - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - María C. Iglesias Moreno
- Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Clínico San Carlos e- IdISCC, Madrid, Spain
| | - Esther Vilajosana Altamis
- Head and Neck Cancer Unit, Department of Medical Oncology, Catalan Institute of Oncology (ICO – L’Hospitalet de Llobregat), Barcelona, Spain
| | - Lorena Arribas Hortigüela
- Clinical Nutrition Unit, Catalan Institute of Oncology (ICO – L’Hospitalet de Llobregat), Barcelona, Spain
| | - Miren Taberna Sanz
- Head and Neck Cancer Unit, Department of Medical Oncology, Catalan Institute of Oncology (ICO – L’Hospitalet de Llobregat), Barcelona, Spain
- Oncobell Program - Bellvitge Biomedical Research Institute (Institut d'Investigació Biomèdica de Bellvitge), Barcelona, Spain
| | - Pedro Pérez-Segura
- Head and Neck Cancer Unit, Department of Medical Oncology, Hospital Universitario Clínico San Carlos - Instituto de Investigación Sanitaria Hospital Clínica San Carlos, Madrid, Spain
| | - Ricard Mesía
- Department of Medical Oncology, Catalan Institute of Oncology (ICO-Badalona), B-ARGO group, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Barcelona, Spain
- *Correspondence: Marc Oliva, ; Ricard Mesía,
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