A comparison of cetuximab-containing regimens for recurrent/metastatic squamous cell head and neck carcinoma: the clinical significance of weekly paclitaxel and cetuximab

Background

The combination chemotherapy of weekly paclitaxel and cetuximab has been a treatment option for recurrent/metastatic squamous cell carcinoma of head and neck (R/M SCCHN); however, the effectiveness of the regimen has been not yet been compared with the current standard regimen, EXTREME (combination of 5-FU, cisplatin and cetuximab).

Methods

We retrospectively reviewed the clinical records of R/M SCCHN patients who received cetuximab-containing chemotherapy as 1st line; of them, patients receiving weekly paclitaxel and cetuximab regimen (cohort A) and the EXTREME regimen (cohort B) were extracted. The responses, prognoses and adverse events of these two regimens were evaluated.

Results

A total of 86 patients were included (cohort A: 49, cohort B: 36). Patients with histories of platinum-based chemotherapy were more allocated in cohort A. Though the response rates were similar in each cohort (44.9 % in cohort A and 51.4 % in cohort B; p = 0.83), the progression-free survival (PFS) was significantly more favorable in cohort A, as shown by the log-rank test (6.0 months vs 5.0 months; p = 0.027). The overall survival (OS) was also longer in cohort A, but there was no statistically significance (16.8 months vs 11.8 months; p = 0.072). In the Cox-regression hazard analyses, male sex (hazard ratio [HR] = 2.1, p = 0.010), older age (≥ 70 yo) (HR = 5.0, p = 0.018), PS 0 (HR = 2.2, p = 0.027), the absence of histories of platinum chemotherapy (HR = 3.2, p = 0.003) and the presence of tracheostoma (HR = 2.3, p = 0.039) were favorable factors of cohort A.

Conclusions

In our retrospective analyses, R/M SCCHN patients receiving weekly paclitaxel and cetuximab showed longer PFS than those receiving the EXTREME regimen. In selected patients, the combination of weekly paclitaxel and cetuximab could be the better treatment option.

Clinical trial identification

Legal entity responsible for the study

Cancer Institute Hospital

Funding

Cancer Institute Hospital

Disclosure

K. Nakano: Personal fees for lectures and advisory board services of Eisai Pharmaceutical, GlaxoSmithKline, MSD Serono, Novartis and Taiho Pharmaceutical outside the submitted work. All other authors have declared no conflicts of interest.