The addition of cetuximab (Cmab) to platinum-based chemotherapy demonstrated significant improvement of overall survival (OS) in the first line treatment of patients with R/M SCCHN. However, the role of Cmab maintenance after chemotherapy remains unclear. We conducted a retrospective analysis to evaluate the safety and efficacy of Cmab maintenance for R/M SCCHN.
We reviewed the clinical records of 46 patients with R/M SCCHN treated Cmab in combination with chemotherapy at our institute between February 2012 to September 2014; median age: 65 years (36-75), PS 0/1/2: 27/18/1, Oral cavity/ oropharynx/ hypopharynx/ larynx/ nasal cavity/ others: 16/7/12/4/5/2, no. of prior chemotherapy; 0/1/2 = 38/6/2, chemotherapy regimen with Cmab: platinum + 5-FU(PF)/paclitaxel + CBDCA(PC): 16/30. All patients continued Cmab maintenance until disease progressed or unacceptable toxicities were observed.
Median duration of Cmab treatment was 4 months (0-22). Median number of Cmab administration was 18 (2-89). Nine patients (19.6%) continued Cmab maintenance more than 6 months. The main reason of discontinuation of Cmab maintenance was disease progression (69.6%). Five patients discontinued Cmab maintenance due to adverse events included infection (4 patients) and interstitial pneumonia (1 patient). The most common grade 4 adverse events (AEs) during chemotherapy were neutropenia (13.0%) and sepsis (4.3%), while no grade 4 AE was observed during Cmab maintenance. Median PFS was 5.5 months and 1-year PFS was 31%. Median OS was 16.2 months. There was no significant difference in OS between two chemotherapy regimes (median OS; 15.3 month for PF, 16.2 months for PC).
Cmab maintenace was well tolerated and could result in durable response and long term survival. PC plus Cmab may be a good alternative option for R/M SCCHN.
Clinical trial identification
M. Tahara: personal fees from Merck Serono, Merck Sharp & Dohme, Bristol-Myers Squibb, Bayer, Eisai and Otsuka grants from Boehringer Ingelheim and Astra Zeneca, outside the submitted work. All other authors have declared no conflicts of interest.