377P - Induction chemotherapy with APF (bevacizumab + cisplatin + 5-fluorouracil) for betel-nut-chewing associated head and neck squamous cell carcinoma -...

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer Agents
Head and Neck Cancers
Presenter Huai-Cheng Huang
Citation Annals of Oncology (2016) 27 (suppl_9): ix112-ix122. 10.1093/annonc/mdw587
Authors H. Huang, R. Hong
  • Department Of Oncology, National Taiwan University Hospital, 100 - Taipei/TW



Head and neck squamous cell carcinoma (HNSCC) in Taiwan is associated with betel-nut chewing. Indcution chemotherapy with TPF is standard after the TAX324 trial. But the side effects of TPF regimen is of concern in Asia. 12% neutropenic fever and 83% grade 3/4 neutropenia were found in the TAX 324 study. We hypothesise the APF regimen may avoid taxotere-related toxicity and retain treatment efficacy. This retrospective study was aimed at evaluating the efficacy of APF for this population.


Patients with locally HNSCC were retrospectively reviewed in a university hospitall in Taiwan from Oct 2014 to Dec 2015. Patients receiving induction chemtoherapy wtih APF for curative intent were recorded for analysis. The history of alcohol drinking, betel nut chewing, and cigarette smoking were coded according to medical records. The clinical response described in medical records and image reports were retrieved.


Twenty-seven HNSCC patients receiving induction chemotherapy with APF for curative intent were recorded. In this population, 26 (96%) were male, 9 (33.3%) were oral cavity HNSCC, 6 (22.2%) were oropharynx HNSCC, 11 (40.7%) were hypopharynx HNSCC. 18 (66.7%) had history of betel-nut chewing, 24 (88.9%) had history of smoking, 20 (74.1%) had history of alcohol drinking. 24 (88.9%) were clinical stage III, IVa and IVb. The response rate after indcution chemotherapy with APF(1∼3 cycles, median 2 cycles) were 92.6%. 4 (14.8%) patients were in complete remission, 3 (11.1%) patients were in pathologic complete remission. 4 (14.8%) patients had grade 3/4 neutropenia, 1 (3.7%) patient had neutropenic fever, 1 (3.7%) had grade 3 acute kidney injury. No tumor bleeding, nor treatment related death was recorded.


The effect of induction chemotherapy with APF for betel-nut-chewing-associated HNSCC is comparative to other studies with TPF regimen. And the side effect profile of APF was acceptable. Further confirmatory studies of induction chemtherapy with APF for this population are mandatory.

Clinical trial indentification

Legal entity responsible for the study

Huai-Cheng Huang


National Taiwan University Hospital


All authors have declared no conflicts of interest.