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The role of cetuximab maintenance after chemotherapy in patients with recurrent/metastatic squamous cell carcinoma of head and neck (R/M SCCHN): A retrospective analysis

Date

20 Dec 2015

Session

Poster presentation 2

Presenters

Tetsuro Wakasugi

Citation

Annals of Oncology (2015) 26 (suppl_9): 93-102. 10.1093/annonc/mdv527

Authors

T. Wakasugi, T. Enokida, A. Nakanome, T. Yamazaki, S. Okano, M. Tahara

Author affiliations

  • Head And Neck Medical Oncology, National Cancer Center Hospital East, 277-8577 - Kashiwa/JP
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Resources

Aim/Background

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.

Methods

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.

Results

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).

Conclusions

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

Disclosure

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.

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